SUMMARY:
This position is responsible for leading the definition and development of Billing and Finance capabilities, as applicable to government healthcare programs, on the company technology platform as well as BPO services. This individual will also work closely in shaping the standardization and use of such capabilities by our health plan clients as well as our BPO services teams. This person deeply understands the technical functioning of the current system and is also able to architect business solutions based on industry knowledge and market research. The individual is able to apply innovative thinking to solve client needs and monetize new feature and functionality effectively.
RESPONSIBILITIES/TASKS:
* Leads key product definition, prioritization, and launch decisions
* Evaluates customer requests for capabilities, industry drivers, and competition to determine product priorities.
* Contributes product strategy and scope decisions based on internal and external factors.
* Defines standard solutions for prospects, including company products and their integration with third party solutions, if necessary
* Manages product readiness and rollout for Government Services solution, with direction from Director of Product Management
* Evaluates client requests, industry drivers, and competitor capabilities to identify enhancements
* Evaluates regulatory changes to determine how they should be accommodated in products.
* Monitors product roadmap priorities and works with Product delivery teams to ensure development work is prioritized.
* Collaborates with Sales and industry consultants on RFPs and sales initiatives.
* Collaborates with Marketing to effectively communicate value of product and overall solution.
* Stays abreast of market changes, represents products at industry conferences, and develops white papers.
* Provides direction on use cases for product enhancements and new products to product and technical team.
* Provides final acceptance and signoff on deliverables from product delivery area
* Serves as the liaison with clients, communicates upcoming system changes, future direction of the product, and serves as industry expert for the product.
* Works effectively with senior leaders and functional teams to ensure success.
This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.
EMPLOYMENT QUALIFICATIONS:
EDUCATION:
Bachelor of Arts or Science Degree required. Advanced Degree preferred. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.
EXPERIENCE:
With proper education credentials, ten years of business and data analysis experience. At least 5 years of experience in Medicare or Medicaid Billing applications, solution development and business functionality. At least 5 years of experience directly working with health plans in developing or commercializing Medicare and Medicaid Solutions, or relevant experience which provides the necessary skills, knowledge, and abilities. The above minimum requirements may be fulfilled in tandem and do not have to be sequential or separate.
SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
* Healthcare industry experience with payers, third party administrators, benefit consultants, or healthcare IT preferred.
* Exposure to Agile development methodologies such as SCRUM.
* Experience delivering product and/or projects to large-scale enterprises.
* Expertise in defining and prioritizing business requirements, and validating product capabilities.
* Excellent organizational, communication, and presentation skills.
* Ability to manage competing priorities and understand the downstream implications of shifting priorities.
* Ability to facilitate the completion of work in a matrix environment.
* Ability to analyze information and to evaluate the implications of a course of action or solution.
* Ability to interpret and apply common sense understanding to carry out a variety of instructions furnished in written, oral, or diagram form.
* Ability to solve problems and deal with a variety of concrete variables in situations where only limited standardization exists.
* Strong interpersonal skills with a collaborative style.
* Demonstrated ability to use sound judgment and discretion regarding confidential information.
* Ability to find common ground and can gain collaboration amongst management, colleagues, and peers, and influence outcomes without directing or commanding.
* Ability to manage a team of direct reports.
* Relationship management skills.
* A demonstrated track record of working with minimal supervision, being a self-starter, and working with others in a team environment.
* A demonstrated track record of consistently meeting and/or exceeding performance expectations.
* Strong implementation, problem solving, and analytical skills.
* Excellent project and time management skills.
WORKING CONDITIONS:
Work is performed in an office setting with no unusual hazards.
The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.
We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.
