Product Health System Manager Job at Inland Empire Health Plans
Position Summary/Position
Primary point of contact for coordination of work related to Claims/Eligibility Administration and Transactional Processing System and/or Medical Management System (MMS) at IEHP. Position will be responsible for ensuring production stability of the environment, as well as enhancement projects, system upgrades, and vendor relationship. Position will be liaison between IEHP and vendor, responsible for follow up, communication, escalation and driving resolution of issues. Major Functions (Duties and Responsibilities)
1. Manage the relationship with vendor including being the primary point of contact between IEHP and specific vendor.
2. Organize and lead the periodic business review process between IEHP and vendor executive and/or development team(s).
3. Evaluate new module offerings from Provider against areas of improvement identified by IEHP via enhancement requests or workaround documentation and present to Management as appropriate to meet business needs.
4. Establish and design processes, best practices, to be utilized by all Product Management Specialists.
5. Drives root cause analysis and corrective action with the vendor, and/or with internal teams for issue resolution.
6. Facilitate the healthy and effective two-way communication between vendor and IEHP, ensure that the vendor is adequately supporting IEHP.
7. Cost management and invoice tracking related to specific vendor against available contracted funds.
8. Act as primary liaison to vendor for general product support, training, requests, and communication.
9. Create, maintain, and support project plan related to releases with the ability to meet defined deadlines.
10. Work with All IEHP teams to capture, prioritize, and define future enhancements, and helping define the product roadmap as it applies to IEHP.
11. Facilitate the initiation and roll out of related initiatives and enhancements with impacted IEHP resources, both IT and business units. Major Functions (Duties and Responsibilities) Cont Supervisory Responsibilities Leading: Self Experience Qualifications
Five plus (5+) years health care support experience. Program/Project management experience required. Two plus (2+) years previous experience with specified vendor for Claims/Eligibility Administration and Transactional Processing System or Medical Management System with established relationships at said vendor. Preferred Experience
IEHP IT support experience preferred. Education Qualifications
Bachelor’s degree from an accredited institution required.
In lieu of the required degree, a minimum of four (4) years of additional relevant work experience in managed care support or specific vendor management role is required for this position. This experience is in addition to the minimum years listed in the Experience Requirements above. Preferred Education Professional Certification
Project Management Professional (PMP) Certification preferred. Professional Licenses Drivers License Required Yes, must have a valid California Driver's License. Knowledge Requirement
Strength in communication along all levels, including business teams, IT teams, and senior management. Ability to manage contract and costs associated with those contracts. Manage invoices and custom requests, as well as knowing when to escalate. Ability to manage the vendor deliverables and ensure timely and successful delivery. Skills Requirement
Required skill: Aptitude for influencing others – various stakeholders at all levels of the organization. Proven ability to manage varying areas of support. Exceptional communication and interpersonal skills.
Process oriented focus. Drive root cause analysis and helps with the corrective action development to meet all affected area needs. Intermediate skill with Microsoft Office products (i.e., Word, Excel). Abilities Requirement
Ability to learn quickly to ensure rapid transition into and adoption of industry terminology. Strength in communication along all levels, including business teams, IT teams, and senior management. Ability to manage contract and costs associated with those contracts. Manage invoices and custom requests, as well as knowing when to escalate. Ability to manage the vendor deliverables and ensure timely and successful delivery. The ability to be personable and tenacious as a situation requires. Extremely organized and proficient at tracking and monitoring. Commitment to Team Culture
The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization. Working Conditions
Position is eligible for Hybrid work location upon completing the necessary steps and receiving HR approval. All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership. Work Model Location Hybrid Physical Requirements Keyboarding: Traditional - FREQUENTLY Keyboarding: 10-Key - FREQUENTLY Keyboarding: Touch-Screen - FREQUENTLY Hearing: One-on-One - FREQUENTLY Communicate: Information/ideas verbally - FREQUENTLY Near Visual Acuity - FREQUENTLY Regular contacts: co-workers, supervisor - FREQUENTLY Memory - FREQUENTLY Understand and follow direction - FREQUENTLY Regular and reliable attendance - CONSTANTLY Sitting - CONSTANTLY Lighting - CONSTANTLY Indoors - FREQUENTLY
A reasonable salary expectation is between $91,000.00 and $116,022.40, based upon experience and internal equity.
Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work.” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.
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Primary point of contact for coordination of work related to Claims/Eligibility Administration and Transactional Processing System and/or Medical Management System (MMS) at IEHP. Position will be responsible for ensuring production stability of the environment, as well as enhancement projects, system upgrades, and vendor relationship. Position will be liaison between IEHP and vendor, responsible for follow up, communication, escalation and driving resolution of issues. Major Functions (Duties and Responsibilities)
1. Manage the relationship with vendor including being the primary point of contact between IEHP and specific vendor.
2. Organize and lead the periodic business review process between IEHP and vendor executive and/or development team(s).
3. Evaluate new module offerings from Provider against areas of improvement identified by IEHP via enhancement requests or workaround documentation and present to Management as appropriate to meet business needs.
4. Establish and design processes, best practices, to be utilized by all Product Management Specialists.
5. Drives root cause analysis and corrective action with the vendor, and/or with internal teams for issue resolution.
6. Facilitate the healthy and effective two-way communication between vendor and IEHP, ensure that the vendor is adequately supporting IEHP.
7. Cost management and invoice tracking related to specific vendor against available contracted funds.
8. Act as primary liaison to vendor for general product support, training, requests, and communication.
9. Create, maintain, and support project plan related to releases with the ability to meet defined deadlines.
10. Work with All IEHP teams to capture, prioritize, and define future enhancements, and helping define the product roadmap as it applies to IEHP.
11. Facilitate the initiation and roll out of related initiatives and enhancements with impacted IEHP resources, both IT and business units. Major Functions (Duties and Responsibilities) Cont Supervisory Responsibilities Leading: Self Experience Qualifications
Five plus (5+) years health care support experience. Program/Project management experience required. Two plus (2+) years previous experience with specified vendor for Claims/Eligibility Administration and Transactional Processing System or Medical Management System with established relationships at said vendor. Preferred Experience
IEHP IT support experience preferred. Education Qualifications
Bachelor’s degree from an accredited institution required.
In lieu of the required degree, a minimum of four (4) years of additional relevant work experience in managed care support or specific vendor management role is required for this position. This experience is in addition to the minimum years listed in the Experience Requirements above. Preferred Education Professional Certification
Project Management Professional (PMP) Certification preferred. Professional Licenses Drivers License Required Yes, must have a valid California Driver's License. Knowledge Requirement
Strength in communication along all levels, including business teams, IT teams, and senior management. Ability to manage contract and costs associated with those contracts. Manage invoices and custom requests, as well as knowing when to escalate. Ability to manage the vendor deliverables and ensure timely and successful delivery. Skills Requirement
Required skill: Aptitude for influencing others – various stakeholders at all levels of the organization. Proven ability to manage varying areas of support. Exceptional communication and interpersonal skills.
Process oriented focus. Drive root cause analysis and helps with the corrective action development to meet all affected area needs. Intermediate skill with Microsoft Office products (i.e., Word, Excel). Abilities Requirement
Ability to learn quickly to ensure rapid transition into and adoption of industry terminology. Strength in communication along all levels, including business teams, IT teams, and senior management. Ability to manage contract and costs associated with those contracts. Manage invoices and custom requests, as well as knowing when to escalate. Ability to manage the vendor deliverables and ensure timely and successful delivery. The ability to be personable and tenacious as a situation requires. Extremely organized and proficient at tracking and monitoring. Commitment to Team Culture
The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization. Working Conditions
Position is eligible for Hybrid work location upon completing the necessary steps and receiving HR approval. All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership. Work Model Location Hybrid Physical Requirements Keyboarding: Traditional - FREQUENTLY Keyboarding: 10-Key - FREQUENTLY Keyboarding: Touch-Screen - FREQUENTLY Hearing: One-on-One - FREQUENTLY Communicate: Information/ideas verbally - FREQUENTLY Near Visual Acuity - FREQUENTLY Regular contacts: co-workers, supervisor - FREQUENTLY Memory - FREQUENTLY Understand and follow direction - FREQUENTLY Regular and reliable attendance - CONSTANTLY Sitting - CONSTANTLY Lighting - CONSTANTLY Indoors - FREQUENTLY
A reasonable salary expectation is between $91,000.00 and $116,022.40, based upon experience and internal equity.
Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work.” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.
Please Note :
clarksqn.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, clarksqn.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.