DTS Market Implementation Director

Job Number: 2761

Workplace Type:

Position Title: DTS Market Implementation Director

External Description:

DTS Market Implementation Director

 

Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery model, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.

By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community.

Position Summary:
Alignment Healthcare is a data and technology driven healthcare company focused on partnering with health systems, health plans and provider groups to provide care delivery that is preventive, convenient, coordinated, and that results in improved clinical outcomes for seniors.

 

Alignment’s Market Implementation team is part of the technology organization and is responsible for the program management and operational implementation of existing and new products and services across the Alignment enterprise. 

 

We are currently seeking a Data & Technology Solutions (DTS) Market Implementation Director. This position will play a key role in implementing our existing and new Medicare Advantage products in S&M, Operations, Network Management, Clinical and Compliance in our existing work processes and on our AVA technology platform.  The AVA proprietary technology and rich data platform interoperates on the Microsoft Azure cloud services, and incorporates machine learning and big data technologies.

 

General Duties/Responsibilities:

(May include but are not limited to)

 

• Program Development:
• Refine/Develop Market Implementation (M/I) program playbooks and framework methodologies in collaboration with the Market Implementation leadership team and deploy successfully with our business partners.
• Refinement and development of the M/I master program plan and schedule including but not limited to key program artifacts (RAID, contact list, weekly program updates (written and verbal), Medicare Advantage (MA) product roadmap, EDI interface schedule, etc.
• Hands-on program direct key tasks and deliverables for the technology, operations, and clinical teams.
• Work with the M/I leader on refinement of the M/I budget and associated rationale for each investment.
• Communicate with Business Partners, software vendors, and internal departments.
• Participate in project meetings, providing input to project plans and providing status updates.
• Define and oversee program milestones and product releases in alignment with company’s annual calendar and strategic plan.
• Effectively prioritize initiatives, tasks, and projects to ensure that the most critical needs are being met as efficiently as possible.
• Mentor project team members, and vendor teams to help them be successful in their roles and to develop and improve skill sets.

 

 

 

• Interface to Technology Team:
• Program direct the technology operations team in a way that emphasizes collaboration, enables innovation, and values customer service, technical proficiency and continuous learning; resulting in successful outcomes.
• Develop/Refine the program plan and provide program oversight and tracking for the technology team
• Setup and facilitate meetings with technology teams to focus on Market Implementation tasks
• Develop and manage the Model Office implementation (Setup, Test case development, test case scorecard, final Model office approval)
• Data interfaces with CMS, provider groups, and supplemental benefits (developed through the AVA data team)
• Reports and Alignment insights enhancements
• Understand and document in the project plan AVA Strategic Initiative development and create an impact analysis (risk, timing, etc.) on the M/I project plan

 

• Interface to Business Teams:
• Program direct the technology operations team in a way that emphasizes collaboration, enables innovation, and values customer service, technical proficiency and continuous learning; resulting in successful outcomes.
• Develop/Refine the program plan and provide program oversight and tracking for the business teams (Operations, Clinical, Sales & Marketing, Network, Compliance)
• Work with business teams to refine requirements processes and improve the intake, development, and delivery Setup
• Facilitate meetings and draft documents with business owners to gather tactical operational requirements and solutions with anticipated and documented business outcomes.
  • Communicate with Business Partners, software vendors, and internal departments as required.
  • Participate in project meetings, providing input to project plans and providing status updates.
  • Track M/I related sprint milestones and product releases/tasks in alignment with M/I project plan.

 

Minimum Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

1. Minimum Experience:
   1. 7+ Years of hands-on healthcare program delivery and management experience.
   2. 7+ years of proven capability, expertise and demonstrated successful outcomes in leading combined technology and ops/clinical workgroups thru large platform and process implementations
   3. 10+ years of healthcare (direct experience with Medicare Advantage a plus) experience
   4. 10+ years of direct healthcare application experience including hands on experience with operational (e.g. Claims, Provider/Network, Capitation, Membership, and clinical process, business drivers, data, and terminology (UM, CM, DM, EMR)
   5. Extensive hands-on experience with Microsoft Office Suite – MS Project, MS Excel, MS Powerpoint, PowerBI
   6. Working knowledge and hands-on experience Azure Dev-Ops
   7. Demonstrated analytical and reporting skills.
   8. Demonstrated ability to build partnerships and maintain cohesive relationships.
   9. Demonstrated ability planning, organizing, and executing multiple complex analytics projects.
2. Education/Licensure:
   1. Bachelor’s of Science Degree (BS) in Computer Science, MIS or equivalent.
   2. Master’s Degree (MA) preferred but not required – MBA, MS Computer Science, other.
3. Other:

1. 1. Hands-on successful experience in working, communicating, and navigating with the C-suite level audience
   2. Strong appreciation of timeliness and the ability to multitask and accomplish assigned tasks within project timelines.
   3. Ability to effectively present information and respond to questions from groups of managers and customers.
   4. Excellent human relations and verbal/written communication skills.
   5. Effective negotiation skills.
2. Work Environment
3. 1. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

 

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact [email protected].

City: Remote - CA

State: California

Location City: Remote - CA

Location State: California

Community / Marketing Title: DTS Market Implementation Director

Company Profile:

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

EEO Employer Verbiage:

 

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].