Implementation Manager - (Remote US)

Utah, Armed Forces Americas, Virginia

Remote position available

Job Description

This position`s primary functions are researching benefit related inquiries, leading benefit projects, taking ownership of duties for assigned coding and audit accounts, gathering and analyzing benefit setup and coding requirements, testing and validating benefit setups, and effectively communicating all benefit changes to stakeholders through technical documentation. The Plan Administration team as a whole is responsible for the plan benefit management and coding of multiple lines of business (Commercial, Medicaid, Medicare, Affordable Care Act Exchange, and Managed Care) across a number of different adjudication platforms. This position will ensure a high level of quality and accuracy through pharmacy benefit analysis, peer auditing, and strong relationship building with our internal Quality Assurance (QA) resources.

SUMMARY

Leads and manages implementation activities for MAPD, Medicaid, Duals, Exchange, EGWP and Commercial lines of business and manage the day-to-day account relationship for assigned clients post-implementation.  Develops strong relationships with internal partners that support achievement of strategic alignment (IT, Finance, Product Development, Claims, Legal etc.).  Takes the leadership role in coordinating these resources to achieve business objectives, maintain account satisfaction, and ensures that the company’s products and services support customer’s needs.

Additional responsibilities will include the following, as assigned:

Implementation

  • Lead project plan development and facilitate implementation of strategic (complex, national, multiple lines of business, etc.) new client implementations.
  • Act as consultative client liaison between all MRx functional areas and client contacts (including client, TPA, broker and /or consultant parties).
  • Define project scope, develop project plan, determine necessary resources and establish project timeline.
  • Work on complex projects that fall outside of standard implementation processes.
  • Provide strategic direction and guidance to both internal operational functions and client to identify and mitigate project risks to all parties.
  • Able to clearly understand and communicate client intent, identify the best way to implement to  minimize disruption impact to beneficiaries.
  • Identify and manage project dependencies, risks and issues.
  • Identify process inefficiencies and provide innovative solutions to solve for gaps.
  • Ensure quality and service standards are met; including client contractual deliverables related to the implementation process.
  • Meet regularly with client to determine service requirements and expectations for overall satisfaction.
  • Provide executive-level updates and presentations to internal staff.
  • Contractual compliance, organizational risk identification/mitigation, escalated issue resolution, and sales support are required. 
  • Conduct project post-mortems, identify recommendations for improvement based on lessons learned, and implement changes.
  • Identify both successful and unsuccessful project elements and establish best practices for project execution.
  • Work with sales and marketing to establish implementation process and operational procedures for new products.
  • Identify opportunities to standardize, document and define procedures.
  • Identify process inefficiencies and provide innovative solutions to solve for gaps.
  • Act as mentor to new Implementation Project Managers.
  • Other duties as assigned by manager.

Required Qualifications

  • Argus/DST/SS&C System Expertise
  • Implementation experience in Medicaid, Medicare, Duals, EGWP and Exchanges
  • 5+ years of client relationship management experience, with proven client implementation and project management experience, within a healthcare/PBM, account services, customer service, non-IT client implementations, or related industry.
  • Extensive knowledge of government programs, requirements, regulations and risks, including 3+ years of experience supporting government programs, i.e. Medicare Part D, Medicaid, EGWP’s, Exchange.
  • Ability to travel 25%-40%.

Preferred Qualifications

  • Bachelor’s Degree
  • Prior leadership experience
  • Certification in Project Management

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General Job Information

Title

Implementation Manager - (Remote US)

Grade

25

Job Family

General Services Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

6/21/2019

Date Requisition Created

2/13/2019

Work Experience

Analytics/Informatics

Education

A Combination of Education and Work Experience May Be Considered. (Required), Bachelors: Computer and Information Science (Required)

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

  • Minimum of 3 years of systems analysis experience in appropriate technical environment.
  • 5+ years of experience in analysis.
  • Related professional experience in the managed care, healthcare, or insurance industries.
  • Analytical/problem solving skills, excellent verbal and written communication skills, strong PC background, efficient in using standard software.
  • Knowledge of system process analysis and/or program management, estimating IT system development and testing.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.