Oversees the strategic planning and administration of the end-to-end product lifecycle for all VNSNY CHOICE products and services, focusing on product growth and performance against defined goals and criteria. Collaborates with CHOICE leadership in the development of a business plan that is aligned with CHOICE strategic goals and objectives. Leads development, design, and implementation of new products and oversees changes to improve existing products. Establishes budgets and metrics used to evaluate products. Also oversees delegated vendor operations. Ensures compliance with all applicable contracts and government regulations. Works under general supervision.
- Collaborates with CHOICE leadership in establishing department short to medium strategic goals.
- Collaborates with VNSNY CHOICE leadership to establish business outsourcing strategy, evaluate outsourcing needs and requirements, and establish the strategic direction as it relates to business partner operations.
- Creates business plans and monitors P&L for each product. Leads the product-level management process to ensure that all functional areas meet or exceed goals for key metrics, and that risks and opportunities to the plan are escalated and addressed appropriately. Identifies and addresses key profitability drivers and develops and executes plans to mitigate business risks.
- Oversees new product development process, including identifying new business ventures and strengthening internal operations to competitively differentiate VNSNY CHOICE. Evaluates opportunities from a market and financial standpoint to ensure the continued viability of the organization. Ensures timely implementation and execution of new products, including compliance with contractual and regulatory requirements.
- Analyzes trends in volume, utilization, and other business drivers to understand the impact these factors have on financial performance. Implements operational changes based on analysis.
- Oversees policies, workflows, systems, staffing, collateral and pricing to ensure high qualityproduct performance, including member experience, operational efficiency, quality and financial performance.
- Oversees all applicable bid, planning, marketing and certification processes for existing products, leveraging resources in other departments.
- Overseees the creation, review and approval of collateral and advertising marketing materials for all products and services to ensure compliance and messaging.
- Evaluates member satisfaction survey results for all products; makes recommendations to improve satisfaction, as appropriate.
- Oversees management of vendors, to whom the plan has delegated responsibility. Ensures all due diligence activities are in place prior to the implementation of vendor relationships including annual or as-needed vendor audits. Works with leadership to develop and manage quality improvement and corrective action plans based on audit findings and vendor performance; communicates results.
- Assists senior leadership in building strong coherent relationship with the regulators) by providing subject matter and operational insights. Works with the government affairs team to assist in matters of strategic importance to the organization.
- Provides oversight of vendor management for all contracts, including facilitating governance relationships between CHOICE and delegated vendors andparticipating in joint oversight committee meetings. Ensures all sourcing activities are formalized and in line with existing vendor contracts.
- Keeps abreast of changes and trends in the external environment (competitor offerings, DOH/CMS regulations, coalition/affiliation group positions, provider network, membership needs); synthesizes trends and determines application for product development and management for CHOICE products.
- Represents VNSNY CHOICE at government/state/regulatory agencies. Communicates and interprets contract amendments, leading implementation to ensure compliance.
- Performs all duties inherent in a senior managerial role. Ensures effective staff training, evaluates staff performance, provides input for the development of the department budget, and hires, promotes, and terminates staff and recommends salary actions, as appropriate.
- Participates in special projects and performs other duties as assigned.
Master's degree in Business Administration, Public Administrationorrelated field required.
Minimum of ten years progressive managerial experience in health care administration, planning and financial oversight required. Project management and managed care experience required. Knowledge and understanding of Medicare and Medicaid regulations required. Demonstrated knowledge of Health Plan product assessment and development required. Demonstrated ability to manage P&L for Medicare/Medicaid plans required. Demonstrated ability to collaborate and interact cooperatively with all levels of management and their staff required. Knowledge of delegation oversight required. Strong problem solving and decision making skills required. Excellent communication skills and proficiency with computer and software programs (e.g.; Microsoft Word, Excel) and the Internet required.
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