Martin’s Point Health Care Hiring For Manager Health Plan Products at Portland, ME, United States Full Time

Job Description

Join Martin’s Point Health Care – an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of “people caring for people,” Martin’s Point employees are on a mission to transform our health care system while creating a healthier community. Martin’s Point employees enjoy an organizational culture of trust and respect, where our values – taking care of ourselves and others, continuous learning, helping each other, and having fun – are brought to life every day. Join us and find out for yourself why Martin’s Point has been certified as a “Great Place to Work” since 2015.

Please note that all Martin’s Point Health Care employees must be fully vaccinated against COVID-19 as a condition of employment.
Position Summary

The Manager, Health Plan Products (MHPP) is responsible for leading and driving innovation and growth in support of Martin’s Point’s short and long-term product portfolio strategy. This includes management for existing lines of government health plan products, as well as promoting standard work for related core business functions.

This position leads product strategy, design, and implementation through comprehensive project management, presenting complex information relevant to strategy and operations across all levels of the organization. Partnering with Health Plan department leaders, Compliance & Legal, Finance, and Marketing teams, the MHPP will support the above through research & coordination of government and regulatory affairs, industry best practices and innovation, financial and market assessments, population health strategies, operational and clinical integration, and health plan administration governance.

Key Outcomes:

• Develops and maintain knowledge and expertise in regional and national managed health care trends and best practices, competitive landscape, population profiles, and community partners.
• Leads Product team to align operations and strategy with best practices that enhance both product and business performance.
• Ensures compliance with CMS, DHA, DoD, DHHS, and other guidelines as applicable by product line.
• Partners with appropriate Health Plan teams and Legal & Compliance on assessment, contracting and implementation of vendors, community partnerships, or other delegates to provide support for product strategy and/or benefits and services (vendor/delegate relationships may ultimately be managed outside of the product team).
• With input from stakeholders and team members, responsible for the development of project charters and execution of comprehensive project plans for initiatives assigned by Martin’s Point Senior Leadership.
• For the GA product line, the manager must coordinate interdisciplinary development and execution of Generations Advantage’s annual bid submission to CMS, and implementation of benefits and product changes, including materials, to support the Annual Enrollment Period (AEP) and upcoming plan year.
• For the USFHP the manager will act as backup to TRICARE Records Management Manager to develop and implement internal audits, promote standard work, and coordinate materials and subject matter experts for DHA on-site Records Management audits.

Education/Experience:

• 5 years of progressively more responsible health care administration and leadership experience with strong preference for managed care or government programs experience
• Project Management experience, overseeing projects in matrix environment
• Bachelor’s degree required; will consider a combination of education and experience

Skills/Knowledge/Competencies (Behaviors):

• Broad knowledge of managed care and health plan functions; Medicare Advantage/ USFHP/TRICARE knowledge
• General knowledge of budgeting and finance processes

• Demonstrated Negotiation’s experience
• Demonstrates an understanding of and alignment with Martin’s Point Values.
• Team management. Demonstrated expertise managing teams and multi-disciplinary workgroups in achieving team objectives, without direct authority.
• Demonstrated project management skills overseeing complex projects in matrix environment.
• Strong attention to detail and the ability to multitask.
• Excellent communication and presentation skills, oral and written.
• Strong organizational skills including the ability to work independently and prioritize work.
• Ability to review, interpret and present information to Health Plan Leadership and external partners.
• Ability to lead change and assist in the development of change strategies in support of Health Plan and Organizational goals and objectives.
• Competence with computers and business applications; Microsoft Excel, Word, PowerPoint, Outlook, Access.

There are additional competencies linked to individual contributor, provider and leadership roles. Please consult with your leader to discuss additional competencies that are relevant to your position.
We are an equal opportunity/affirmative action employer.
Do you have a question about careers at Martin’s Point Health Care? Contact us at:
[email protected]