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Program Developer, Clinical Oversight in Southfield, MI at AF Group

Date Posted: 6/24/2018

Job Snapshot

Job Description

COBX - Senior Health Services







SUMMARY:



The Program Developer conceives, organizes, promotes and implements effective programmatic initiatives for Medicare Advantage BCBSM and BCNA. This position provides effective and efficient solutions to complex business problems with delivery of key program designs, business reviews, and business development recommendations. This role is also responsible for strategizing, innovating, analyzing, planning, organizing, identifying requirements, and other functions that are required to maintain and operate efficient and effective MA clinical programs.



RESPONSIBILITIES/TASKS:




  • Utilize current knowledge and experience to recommend competitive and effective clinical program designs.
  • Identify and recommend best in class programs for Medicare Advantage business and provides related data and information to support recommendation.
  • Plans, organizes, and directs activities of assigned programs, including, but not limited to, planning, training, and communication.
  • Maintains and promotes quality relationships with internal and external customers.
  • Compiles and analyzes statistics and prepares activity related reports, manpower needs, and inventories and develops workflows as needed.
  • Leads and participates in workgroups and task forces in order to complete special assignments and projects.
  • Recommends processes to control expenditures and promotes efficient use of resources.
  • Proactively follows-up on open issues with senior leadership, as well as other relevant parties. Research cause and make recommendations.
  • Works with project managers, program managers, and business leads to develop business cases, understand project scheduling and outcomes.
  • Responsible for balancing workload to optimize the effectiveness of the department.





    EMPLOYMENT QUALIFICATIONS:





    EDUCATION:



    Bachelor's degree in Business Administration, Health Care Administration, or a related field. RN preferred. Masters in healthcare administration, business or public health 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



    EXPERIENCE:



    Seven years of multi-faceted experienced experience in healthcare industry preferably Medicare with demonstrated technical knowledge that provides the necessary knowledge, skills, and abilities required. Experience as a clinical program manager/ program developer required.



    SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:




  • Excellent analytical, organizational, planning, verbal, and written communication skills required.
  • Proficient in work that involves analysis, organization, planning, presentation development, problem resolution, strategy, and innovation.
  • Knowledge of Medicare programs preferred.
  • Ability to effectively present information and respond to questions from internal and external contacts at all levels of the organization.
  • Ability to read, analyze, write, and develop communications (i.e. white papers, strategy decks, etc.) or reports as required by leadership.
  • Ability to effectively exchange information, in verbal or written form, by sharing ideas, reporting facts and other information, responding to questions, and employing active listening techniques.
  • Ability to establish workflows, manage multiple projects, and meet necessary deadlines.
  • Ability to interact with others to build consensus and get decisions implemented.
  • Demonstrated task and relationship management skills.
  • Results-oriented and ability to manage multiple tasks simultaneously.
  • Knowledge of Microsoft packages, including Project, PowerPoint, Word, and Excel.
  • Strong understanding of the importance for detail.
  • Skilled at managing stakeholder groups and balancing diplomacy and tact with assertiveness.
  • Excellent prioritization skills to balance key priorities.
  • Strong customer centric approach.
  • Effective in unifying and creating teams of people with disparate skills.
  • Courageous and decisive, prioritizes effectively, maintains a clear focus, and sees action through to delivery.
  • Energetic, determined, positive, goal focused and consistent, even when under pressure.
  • Ability to build trust and demonstrates integrity in all circumstances.



    WORKING CONDITIONS:



    Work is performed in an office setting with no unusual hazards. Occasional travel is required.

    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.

    Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
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