Medicaid Fee-For-Service Operations Manager (Program Manager III)

About this role

Exemption Status: United States of America (Exempt)

$102,260 - $140,608 - $178,955 “Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description This position works within the State of South Carolina, preferably in the area of Columbia, SC.

This position is contingent upon MedImpact's successful award and/or implementation of new business. Employment in this role is dependent upon the final business award, client approval (if applicable), and organizational staffing requirements. MedImpact reserves the right to modify or withdraw this opportunity based on business needs.

Summary The Program Manager III works in one of three areas:  Value Based Care (VBC), Government Programs & Services or PDP (MedGenerations) and is responsible for analyzing, creating new requirements, planning, and delivering updates for assigned programs and related services.

For GPS & MedGenerations specifically, the Program Manager works within one or more regulated market lines of business – Medicare Part D, Marketplace, Prescription Drug Plan (PDP) or the Medicaid plans including: Medicaid Fee for Services (FFS), Medicaid Managed Care (MMCO), Children’s Health Insurance Plan (CHIP).

Essential Duties and Responsibilities include the following. Other duties may be assigned. • Drives the development of the overall strategy and roadmap, research, requirements, and coordination for assigned programs.     • Follows outlined program management processes to manage the overall scope, planning, business requirements, implementation and delivery of software updates and other related requirements to assigned programs. Ensures business requirements are properly translated into customer deliverables. Schedules product release timelines with IT department. Coordinates product development schedules and releases to production. • Drives appropriate work process improvement activities. • New Products: Defines and documents business requirements for new products or services, through market analysis or other innovation strategy. Interfaces with end-users and business analysts to define business rules as they apply to processes and procedures; documents business requirements and develops work- flow diagrams, functional hierarchies, process models, revenue models and fee schedules. Prepares program development objectives and schedules all phases of program development and introduction to clients. Schedules product release timelines with the IT department. Coordinates technical product development and releases to production. • Keeps current with and reviews state and/or federal requirements and regulations related to assigned programs to ensure that programs support client regulatory compliance. • Provides day-to-day management and coordination of deliverables, issue tracking, and compliance issues for assigned programs.  Ensures timely delivery of reports. Communicates to both internal and external clients on status, schedules, and changes. • Coordinates the efforts of multi-disciplinary teams throughout various stages of the program development life-cycle.  Manages large-scale, strategic, complex projects from start to finish and effectively leads project teams comprised of multiple business units. • Develops client communications as needed to explain MedImpact response and/or changes in client responsibilities (related to drug benefit management).  Attends client calls as needed to understand and address questions or issues for assigned programs.

• Maintains documentation for assigned programs including: Program Descriptions, Report Guides, Policies, Procedures, Work Instructions, training materials, etc.  • Serves as an expert resource for the line of business or for Government Programs and Services the focus will be on at least one regulated market, in addition to being a subject matter expert in assigned programs. Educates clients on program features. Provides expertise and training to other departments. 

• Mentors less experienced program management team members and aids in cross training. • Defines metrics to effectively measure the success of program and service processes and deliverables. • Vendor oversight: if applicable for owned programs and services, monitors vendor operations, ensures appropriate metrics and PG’s are in place, and coordinates vendor changes as appropriate with MedImpact automation and/or work processes.

Supervisory Responsibilities No supervisory responsibilities                                     Client Responsibilities This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written).  One must be able to; manage difficult or emotional client situations; Res

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