Lead Health Plan Product Consultant (Hybrid - Troy, MI) - Health Alliance Plan

at  Health Alliance Plan

GENERAL SUMMARY:

Develops and supports strategies and approaches to increase performance and competitive positioning of HAP’s products. Leads and supports high profile initiatives that promote product growth and retention strategies. Ensures that all efforts align with state and federal regulatory requirements set forth in the Patient Protection and Affordable Care Act (PPACA) and Department of Insurance and Financial Services (DIFS) and the Centers for Medicare and Medicaid Services (CMS). Monitors industry trends and competitor offerings and determines the value proposition of new functionality to HAP. Facilitates and documents business requirements development efforts to ensure business needs are met. Serves as the business liaison to technical and vendor partners and ensures that business requirements are fully understood to ensure alignment with delivered solution. Collaborates with business partners that impact HAP products to identify process improvement opportunities, and leads small and larger scale process improvement efforts with defined metrics to measure
outcomes.

EDUCATION/EXPERIENCE REQUIRED:

• Bachelor’s Degree in Business, Health Care Management, Health Care Marketing or related field.
• Master’s Degree in related field considered a plus.
• Minimum of three (3) years of project management, process improvement and process documentation in business and/or healthcare field.
• At least three (3) years of Managed Care or Insurance experience.
• Demonstrated experience in health care or health business organization.
• Highly Proficient in MS Office and related applications.
• Experience with presentations and public speaking.
• Ability to plan, organize, direct and control projects and present complex materials in a clear, concise and persuasive manner.
• Excellent analytical, organizational, interpersonal, problem solving, written and verbal communication skills, as well as the ability to apply concepts to practical situations.
• Ability to work independently with minimal supervision, within a team environment and handle multiple assignments.
• Ability to work collaboratively and professionally with all levels of the organization.
• Excellent organizational and time-management skills.
• Be a self-starter, engaged and committed to the department’s initiatives and goals.
• Proficient technical and software skills.
• Knowledge of managed care concepts and healthcare industry.
• Expertise in project management, time management, and negotiating artfully.
• Demonstrated experience in completing multi-faceted projects with precise coordination, collaboration, and timeliness.
• Willing to work extended hours based on department’s priorities.

• Leads and supports high profile initiatives impacting HAP products. Collaborates with impacted business areas including product development, operations, information technology etc., to assess potential system and operational impacts and incorporate feedback. Develops robust, clearly defined and documented business requirements to ensure that business needs are clearly met and represented. Serves as point person in development of business test cases for product specificinitiatives.
• Serves as the liaison between the business and technical teams to ensure that business requirements are clearly defined, documented and understood. Actively seeks out input from impacted stakeholders including but not limited to product development, operations, and information technology teams to assess potential system and operational impacts and incorporates feedback.
• Supports business case development to determine value proposition of new or enhanced technical solutions. Works closely with operational areas to determine operational efficiencies associated with the new technology and documents findingsin prescribed templates/formats.
• Works closely with and actively seeks input from operational leaders to identify process improvement opportunities within their respective areas. Leads and/or supports process re-design efforts with defined metrics to measure improvementsover time. Documents “as is” and “to be” process flows associated with each.
• Monitors industry and competitor products, trends, and technical solutions, and determines value proposition to HAP. Identifies trends and patterns, assesses competitive opportunities and recommends new or enhanced solutions for consideration.
• Takes ownership of assigned initiatives and serves as a subject matter expert to business area stakeholders. Works with appropriate resources to ensure training and other needed support is delivered to all impacted end users.
• Maintains above average knowledge of Health Care Reform, Health Insurance Market and Government Products to ensure that technical solutions/ functionality aligns with regulations and industry trends.