Director New Business Implementation - Individual Exchange Product
Posted on: November 22, 2021
Your career starts now. We're looking for the next generation of
health care leaders.At AmeriHealth Caritas, we're passionate about
helping people get care, stay well and build healthy communities.
As one of the nation's leaders in health care solutions, we offer
our associates the opportunity to impact the lives of millions of
people through our national footprint of products, services and
award-winning programs. AmeriHealth Caritas is seeking talented,
passionate individuals to join our team. Together we can build
healthier communities. If you want to make a difference, we'd like
to hear from you.Headquartered in Philadelphia, AmeriHealth Caritas
is a mission-driven organization with more than 30 years of
experience. We deliver comprehensive, outcomes-driven care to those
who need it most. We offer integrated managed care products,
pharmaceutical benefit management and specialty pharmacy services,
behavioral health services, and other administrative services.
Discover more about us at
www.amerihealthcaritas.com.Responsibilities:The Director, New
Business Implementation reports to the Exchange Segment President
and is responsible for leading cross-functional business readiness
activities to support new business implementations as AmeriHealth
Caritas enters new ACA exchange markets. The Director, New Business
Implementation directs the insurance application process for new
states, including the Certificate of Authority application process
through to approval and tracking the development and delivery of
all other implementation deliverables. The Director also
coordinates resources to evaluate regulatory questions as they
arise and converts into actionable marketplace approaches and
advocacy strategies. Internally, Director works collaboratively
across the enterprise to identify, document, and communicate
exchange business requirements in support of end-to-end process
development to ensure the successful implementation of Exchange
business operations. The Director, New Business Implementation
works with Customer Experience, Operations, Marketing and other
process domains to optimize AHCs exchange offerings, and
incorporate lessons learned, in each state. The Director is also
responsible for guiding the implementation team with AmeriHealth
Caritas' IT organization to make necessary system and configuration
changes to implement new exchange business. The Director executes
on the exchange segment growth plan, and communicates growth goals
to operations for incremental staff hiring. Another aspect of the
role is to ensure the development of new business policies and
procedures to support operational areas. The Director also provides
guidance to inform the Medicaid RFP process for states that
encourage or require potential Medicaid managed care insurers to
offer exchange products.The Director, New Business Implementation
works on problems of complex scope, requiring the exercise of
independent judgement and the application of a high degree of
subject matter expertise with limited oversight, often requiring
evaluation of multiple competing factors across functional areas.
The Director's contributions will have an impact on the growth,
cost, and customer satisfaction of the Exchange segment. The
Director coordinates the work efforts of medium to large teams,
capable of delivering on several tasks simultaneously within tight
time frames.Directs internal implementation of new ACA markets
- Complex scope in multiple geographiesOversees implementation
financials including business impact:
- Provides accurate performance reporting and forecasting to
managementEstablishes and maintains stakeholder relationships:
- Manages mid/high-level stakeholder relationshipsSupervises
- Supervises the work of full-time employees and contractors of a
team size of less than 15 people
- Provides performance feedback on direct
- Bachelor's Degree.
- Master's Degree.
- Detail oriented, ability to work in "gray areas" towards a
- Strong organizational and communication skills along with the
ability to communicate with all levels in the organization.
- Demonstrated ability to learn and apply the learning in a
business environment. Ability to communicate business and financial
analytics and reports across disciplines and to senior
- Proven ability to work across organizations and rapidly gain /
build trust with stakeholders.
- Advanced proficiency in Microsoft Office Word, Excel, Outlook,
PowerPoint, SharePoint and Visio.
- 5-10 years leading Exchange implementation or similar
implementation leadership roles in Medicaid and/or Medicare.
- Demonstrates a strong working knowledge of key health plan
business functions and capabilities, CMS and state healthcare
regulations, operational policies, processes, and methodologies
applicable to health plan business readiness activities.
- Must be willing to travel up to 25%
- This position is teleworker eligibleBack ShareApply Now
Keywords: Amerihealth, Philadelphia , Director New Business Implementation - Individual Exchange Product, Executive , Philadelphia, Pennsylvania
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