Medical Cost Innovation Strategy Manager
Who We Are
Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.
We enjoy the important work we do every day in service to our members, partners, colleagues and communities.
Under the direction of the Director, Medical Cost Innovation, the Project Manager is responsible for supporting the assessment and planning for Medical Cost Innovation initiatives (and potentially the execution of a few initiatives) across all divisions.
Key Responsibilities/ Essential Functions
Key Responsibilities/Duties – what you will be doing
- Pipeline Development: As part of the core MCI team, participate in developing new ideas and approaches to Medical Cost Innovation mainly through focused research to identify new programs and interventions to address various categories of medical spend by site of service/ diagnostic categories/ body systems
- Assessment and Planning of Initiatives: In collaboration with business owners and stakeholders
- Complete evaluations/ assessments/ business cases
- Support completion of templates and coordination with Actuarial, divisional and other teams for input
- Conduct implementation planning sessions and develops implementation plans/ timelines
- Manage Specific Assessments: In collaboration with stake-holders and business owners, manage the assessment and implementation planning of specific projects
- MCI Tools and Template Management
- Oversee the overall Program Tracker and initiative-specific templates
- Support the Analyst in managing the shared drive that acts as a repository of all MCI documents
Qualifications – What You Need To Perform The Job
EDUCATION: Bachelor's Degree required; Master's or other advanced degree strongly preferred.
EXPERIENCE: 6-8 years experience in a managed care environment; clinical background will be a plus
- Ability to manage major programs with significant cross-functional interface, complexity, risk.
- Able to evaluate the cost and feasibility of multiple options/ alternatives to resolve program issues and make recommendations.
- Highly developed verbal and written skills, ability to facilitate planning and review sessions with senior management, interact effectively with all levels of personnel, facilitate cross-departmental interactions and negotiations to drive consensus, generate creative and innovative ideas with compelling benefits to the organization.
- Strong presentation, time management and organizational skills. Ability to work independently and prioritize multiple demands.
- Requires sufficient comfort with subject matter content areas to manage the process and implementation of programs.
- Strong PC skills with MS Office (Word, Excel & PowerPoint), MS Project, and Visio.
WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS: May require occasional evening or weekend hours as programs dictate. Travel/ overnight stays required on an as needed basis.
CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential. Exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.
Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity
Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.