Commonwealth Care Alliance • Boston, MA 02133
Job #2673347607
Why This Role is Important to Us:
Responsible for consulting with CCA's Ancillary Services and Pharmacy Operations to identify and define business needs that require technology solutions to achieve business outcomes. The portfolio manager ensures that IT solutions are best-in-class and align to CCA's IT and Business strategies.
The portfolio manager directs FTEs, contractors, and IT vendors to identify new technology opportunities to attain operational efficiencies and growth. The manager will function as the IT lead for a portfolio of projects, building a matrixed team of cross- functional experts to deliver projects. The manager will define, lead, coordinate, and sequence technology roadmaps in alignment with the business strategy of Ancillary Services and Pharmacy Operations.
Supervision Exercised: Yes
What You'll Be Doing:
Function as the IT subject matter expert for Ancillary & Pharmacy integrations, platforms, and tools.
Collaborate with IT teams to ensure the seamless data flow and consistency to Ancillary and Pharmacy vendors.
Collaborate with various internal teams and external partners to gather and analyze requirements, ensuring compliance with EDI protocols and standards
Manage performance of IT contractors and vendors.
Lead, Mentor, Train, Supervise, and Manage a team of contracted Product Owners that have the following responsibilities
Develop and maintain relationships with IT, business units and vendors to identify potential opportunities (projects and programs) to improve business operations, and deliver business outcomes.
Consult with business unit's and review IT usage, services, technology, and department specific projects. Identify, forecast and develop IT needs.
Establish subject matter expertise in healthcare business functions and operations to develop business requirements, functional requirements, and test plans
Coordinate the delivery of IT solutions using established project management methodology. Present alternate strategies, new products, and service offerings to improve business efficiencies through technology.
Analyze and report operational and financial impacts of vendors, products and services.
Prepare and submit operational budget and cost estimates for proposed projects to senior management.
Present alternative strategies, new products and service offerings to reduce negative impacts to projects.
Serve as liaison for the Information Technology (IT) department and all other departments and management to identify, forecast and address IT needs.
Establish and maintain business process documentation, compliance and security requirements, and regulatory goals on an ongoing basis and across all programs and projects.
IT project deliverables and milestones including;
User Stories and functional requirements associated with implementing technology to solve for business needs.
Cross-Functional impact analysis of projects and programs
Coordinate project delivery plan across all IT units
Maintain delivery status in the required systems
Reports on usage and metrics
Identify, define, and develop new capabilities, processes, and technologies required for the efficiency of the IT organization.
Develop and maintain continuous improvement techniques to improve the people, processes, and tools.
Lead a metrics driven organization by reporting on portfolio and program status to executive management.
Support IT communications
Research new ways to conduct business operations
Research new technologies and its applicability
Provide ideas to resolve risks and issues to IT leadership team
Participate in learning and development - Maintain active career development plan
Mentor, tutor, and train fellow employees, interns, or consultants
What We're Looking For:
Education:
Four-year college degree
5 years of management experience Or an equivalent combination of education and experience sufficient to successfully perform the essential functions of the job.
Experience Required:
8+ years of experience that has served in multiple roles such as business analyst, programmer, process analyst, project manager, and business consultant.
Comprehensive knowledge of IT infrastructure, applications, and administrative tools
Extensive knowledge of portfolio management and performance monitoring practices and methodologies
Extensive knowledge of business principles
Extensive knowledge of IT organizational practices
Ability to build, maintain and extend relationships across the organization
Leadership and executive-level communication
Ability to manage and direct activities of others in a multi-project environment
Ability to perform business and process analysis
Preferred tools
Atlassian platform tools (JIRA, Confluence, etc.)
Project management and Business Process tools (e.g. Microsoft Project, Bizagi, etc.)
Collaboration tools (e.g. MS Teams, Slack, etc)
Experience Desired:
Agile & Scrum experience
Experience working in the healthcare payer space
Experience with X12 EDI transaction sets for Healthcare, including 834, 837, and 835
Experience working with vendor partners and associated data integrations.
Knowledge, Skills & Abilities Required:
Adapts to change, is open to new ideas, takes on new responsibilities, handles pressure, and adjusts plans to meet changing needs.
Builds customer confidence, is committed to increasing customer satisfaction, sets achievable customer expectations, assumes responsibility for solving customer problems, ensures commitments to customers are met, solicits opinions and ideas from customers, responds to internal customers. Excellent communication skills required.
Recognizes problems and responds, systematically gathers information, sorts through complex issues, seeks input from others, addresses root cause of issues, makes timely decisions, can make difficult decisions, uses consensus when possible, and communicates decisions to others.
Sets challenging and productive goals for team, keeps team accountable for actions, provides leadership and motivation, provides resources and support, uses checkpoints and data to track progress, sets up systems and processes to measure results. Ability to manage program-level portfolio workloads (multi-project scope).
Applies clear/consistent performance standards, handles performance problems decisively and objectively, is direct but tactful, provides guidance and assistance to improve performance.
Conducts positive negotiations, ability to compromise, handles conflict, seeks common ground, articulates own and others goals, stays focused on positive outcome.
Operates within the organization's formal and informal structures, builds allies and relationships across departments, uses allies to build consensus and create results, is appropriately diplomatic, understands others' roles and perspectives, can sell projects and ideas across the organization.
Creates and communicates a long-term vision, balances short and long term goals, keeps own and team's work aligned with overall goals, understands the market and can predict change, understands the industry and the competition, creates and adjusts strategic plans.
Knowledge, Skills & Abilities Desired:
Understanding of the enrollment and claims lifecycles of a medical payer
Knowledge of EDI protocols and standards, such as ANSI X12, EDIFACT, XML, and AS2.
Understanding of EDI mapping and translation tools, such as Gentran, Sterling Integrator, or similar software.
Understanding of database concepts and SQL query language
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
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