About the Position:
We are currently seeking a dynamic Director of Business Implementations to join our team at our office in Norfolk, VA, Latham, NY, or REMOTE.
The Director, Business Implementations independently directs multiple projects or one - strategic client implementation project, which requires considerable resources and high levels of functional integration. S/he is responsible for all aspects of the project over the entire lifecycle, establishes leading role of the project manager in driving goal attainment, schedule adherence and issue resolution. Interfaces with all staff levels across the enterprise. Regularly develops reports for senior management. Identifies and escalates issues to the Senior VP level. Models appropriate communication skills at each level of discussion. Ensures adherence to quality standards, reviews project deliverables, identifies and mitigates risks with the team and provides all stakeholders with weekly status updates. Fosters constructive relationships based on clear, mutual expectations with management up to Senior VP level in all stakeholder groups. Documents and reviews contract requirements with all stakeholders. Ensures the proposed program design is incorporated and that the team adheres to all Beacon Health Options standards.
Duties include direct client interface to implement the agreed upon implementation plan; working with the Boston and Woburn based operations staff to ensure that all operational tasks associated with the implementation are met. These include data file exchanges, co-location planning, clinical model development, quality management practices (HEDIS and OP management), BI/Reporting, compliance, systems configuration, complaints/appeals/grievances, claims payment processes, provider contracting, finance, web site, eServices and other interdependencies impacting the implementation.
- Responsible for effective management and operational set-up of large and complex contract implementations including client interface, internal and external communication and coordination among all implementation leads to ensure an effective and successful implementation occurs. Directs and executes the tasks as defined in the project plan in order to achieve the project goals.
- Works with business leaders to ensure resource availability, workload and performance as well as to drive project vision through effective risk management and manage changes through a defined change management system. Implements the approved actions and workarounds required to mitigate project risk events in order to minimize the impact of the risks on the project
- Measures project performance using appropriate tools and a technique in order to monitor the progress of the project, identify and quantify any variances, perform any required corrective actions, and communicate to all stakeholders.
- Documents high-level risks, assumptions, and constraints using historical data and expert judgment in order to understand project limitations.
- Supervises and mentors Implementation Managers, Associates and Specialists
- Development, oversight and management of required tasks on the implementation work plan
- Assistance to the AVP, Business Implementation on project management activities; including client interface and meetings with state regulatory agencies
- Ensure proper documentation for all documents sent to and received from the client
- Ensure all action items identified during sub group and ad hoc meetings are completed; working closely with Beacon SME’s to trouble shoot and resolve all critical pathways
- Provide weekly implementation status reports, outlining critical pathways and plan for resolution
- Coordinate with the appropriate SMEs to ensure Systems configuration
- Coordinate with Clinical Operations to assess contract specific staffing needs; training plan for new hires and development of a contingency plan for day one in the event new staffed are not hired
- Coordinate and manage the Delegation Review, including the on-site client audit. Work closely with an implementation specialist and other SMEs to develop/gather required documents and policies to meet the contractual requirements.
- Work with the appropriate SMEs to ensure Model Office testing is conducted, QA’d and completed in a timely manner.
- Development of standard Implementation Policies and Workflows
- Staff Training: may be required to facilitate internal and On-site training and support for implementation managers and specialists which includes:
- Level of care criteria
- Call Center
- Management of member and provider letters
- Co-location planning
- Denial and appeals
- Policies and procedures
- Education: MS in health care or business program preferred.
- Relevant Work Experience: 5 years managed care experience required.
- Previous experience in project management and operations needed.
- Knowledge, Skills & Abilities:
- Technology experience and related management experience in multiple business and technical processes, including client and staff management.
- Project Management and planning.
- Ability to handle multiple priorities and meet aggressive deadlines.
- Excellent written, verbal communication and interpersonal skills.
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Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled