Manager, Member Experience & Program Management/ Job Req 772071298

PRINCIPLE RESPONSIBILITIES:

Under the general direction of the Director, Star Strategy and Program Management, the Manager, Member Experience & Program Management is responsible for developing and executing strategies to enhance the overall experience of members for Alameda Alliance for Health's (the Alliance) Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) product. The incumbent will focus on improving member satisfaction, engagement, and retention through effective program management, collaboration with internal stakeholders, and implementation of best practices. In addition, the position will collaborate with the Director, Star Strategy and Program Management and the Executive Director, Medicare Programs, to identify and develop opportunities to ensure a member-centric approach and deliver a high-quality experience throughout the member journey. The position will collaborate with Healthcare Analytics to regularly forecast, build reporting mechanisms, and provide updates to the Medicare Operations leadership if established targets and timelines are at risk. The Manager will have strong experience in developing targeted programs for increasing member experience within Medicare Advantage. Working closely with senior and departmental leadership, the Manager will ensure effective performance and compliance with State and Federal regulatory requirements for all Medicare Advantage D-SNP member program initiatives across the Alliance.

Principle responsibilities include:

• Overseeing and acting as a subject matter expert (SME) in the development and implementation of enterprise-wide performance strategies to enhance the member experience for the Alliance and the Medicare Advantage D-SNP product that is consistent with the vision and mission of the Alliance.
• Developing and leading the execution of a comprehensive strategy focused on improving Star measures, with particular emphasis on key member experience drivers - such as access to care, customer service, and care coordination.
• Monitoring interventions and key Star measures, using data to identify trends, prioritizing interventions, and addressing areas of improvement.
• Conducting targeted outreach to community-based organizations, provider groups, and current members to educate on available benefits, support resources, and service options to ensure optimal experiences.
• Partnering with the Alliance Quality Improvement, Provider Services, and Member Service teams to integrate member experience strategies into broader organizational initiatives and acting as a SME for Medicare to assess performance of the initiatives.
• Collaborating with Alliance leaders to identify and close initial operational and analytical gaps to ensure a successful D-SNP go-to-market launch and performing ongoing assessments to ensure successful operational program management.
• Working cross-collaboratively with diverse staff in teams, working groups, members, providers, elected officials, community partners, and vendors while maintaining and upholding a professional demeanor and representing the Alliance at interviews, special events, official functions, meetings, and when conducting research.
• Maintaining overall creative playbooks, workplans, dashboards, and other project management capabilities to determine effectiveness of plans and activities to ensure on-time production.
• Developing and facilitating educational training sessions to the Alliance organization to better understand the impact of the member experience on Star ratings.
• Creating policies, standard operating procedures (SOPs), productivity standards, roadmaps, reporting, and Key Performance Indicators (KPIs), and performance evaluations in a timely manner.

ESSENTIAL FUNCTIONS OF THE JOB:

• Assumes responsibility and exercises good judgement in making decisions within the scope of authority of the position.
• Be proficient in understanding Centers for Medicare and Medicaid Services (CMS) guidelines, Star Ratings, and the impact of member experience on plan performance.
• Demonstrates strong organizational, time management, and project management skills and multi-tasking abilities.
• Drives projects from ideation to execution with a results-oriented approach.
• Manages small to extra-large level initiatives which may require coordination with external partners.
• Provides support to the Project Management Office (PMO) and various enterprise-wide activities based on availability.
• Organizes and facilitates Medicare member experience project-related meetings, as necessary.
• Works effectively independently as well as part of a team and supports team decisions.
• Adapts to changes in requirements/priorities for daily and specialized tasks.
• Produces accurate and precise work, detects discrepancies, and resolves discrepancies all while meeting deadlines.
• Demonstrates strong analytical skills and problem-solving skills as well as formulates and communicates recommendations for improvements as needed.

PHYSICAL REQUIREMENTS:

• Constant and close visual work at a desk or a computer.
• Constant sitting and working at a desk.
• Constant data entry using a keyboard and/or mouse.
• Frequent use of a telephone headset.
• Constant verbal and written communication with staff and other business associates by telephone, correspondence, or in person.
• Frequent lifting of folders and other objects weighing between 0 and 30 lbs.
• Frequent walking and standing.
• Occasional driving of automobiles.

Number of Employees Directly Supervised: 0-5

Number of Employees Indirectly Supervised: 0-5

MINIMUM QUALIFICATIONS:

EDUCATION OR TRAINING EQUIVALENT TO:

• A Bachelor's degreepreferred or equivalent work experience.

MINIMUM YEARS OF ADDITIONAL RELATED EXPERIENCE:

• Five (5) years of experience in project management, healthcare operations, or Medicare member experience management.
• Three (3) years of experience in the managed care industry with Medicare Advantage related experience.
• Three (3) years supervisory experience.

SPECIAL QUALIFICATIONS (SKILLS, ABILITIES, LICENSE):

• Audit experience preferred.
• Experience in project management, program management, or product development preferred.
• Strong understanding of HEDIS measures, CMS Star Rating methodology, and regulatory requirements.
• Background in health education, health information, and/or general wellness a plus.
• Excellent written, verbal, and interpersonal communication skills, and ability to successfully interact with people at all levels.
• Ability to facilitate meetings, manage complex initiatives, and make presentations before groups consisting of management and staff.
• Exhibits good planning and implementation skills to ensure work is completed on time and to expected quality levels.
• Strong collaboration skills with demonstrated ability to create and foster a collaborative work environment, while maintaining effective, high-performance teams.
• Strong organizational skills with the ability to effectively prioritize multiple tasks and meet deadlines.
• Ability to lead effectively in a matrixed environment.
• Ability to communicate effectively orally and in writing.
• Basic knowledge of the business, economic, demographic, and political trends and developments affecting healthcare in general.
• Intermediate skills in Microsoft Office Suite including Outlook, Word, Excel, Visio, and PowerPoint.
• Ability to manage confidential information with appropriate discretion.
• 5% to 10% occasional travel required.
• Valid CA driver's license, proof of insurance and good driving record.

SALARY RANGE: $110,094.40 - $165,131.20 ANNUALLY

The Alliance is an equal opportunity employer and makes employment decisions on the basis of qualifications and merit. We strive to have the best qualified person in every job. Our policy prohibits unlawful discrimination based on race, color, creed, gender, religion, veteran status, marital status, registered domestic partner status, age, national origin or ancestry, physical or mental disability, medical condition, genetic characteristic, sexual orientation, gender identity or expression, or any other consideration made unlawful by federal, state, or local laws. M/F/Vets/Disabled.