Job Description

Job Title: Director, Medicare SNP
Job ID: 180001JP
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Medicare & SNP Product
Location: 600 Grant St, Pittsburgh PA 15219

Description

The Director Medicare SNP is responsible for oversight of the of UPMC Health Plan's Medicare Advantage SNP products. The Director will ensure regulatory compliance, member satisfaction, membership growth, financial and operational efficiencies. Maintains direct accountability for reporting, compliance, financial analysis and planning and coordination of efforts with other departments to assure effective operations of the both Health Insurance programs.

Responsibilities:

• Develop and implement strategic and tactical plans to ensure further growth and development of the product and ensure positive financial results.
• Ensure that the beneficiaries' needs are well served with a strong emphasis on quality operations and innovation.
• Work closely with other plan and system departments to ensure operational and financial goals are met.
• Develop and maintain excellent internal and excellent relationships with key stakeholders including network providers, community organizations, Centers for Medicare and Medicaid Services and other government organizations.
• Oversee development and execution of business plans and annual operating plan, including employee development, organization goals, network, contracting, and beneficiary and provider relations goals.
• Support operations to achieve favorable financial results.
• Ensure operational compliance with all state and federal regulatory agencies.
• Develop annual and longer-term business plans for SNP products
• Oversee development of benefit design and the annual bid
• Ensure the achievement of product and health plan goals and objectives, including budget goals
• Develop new products as appropriate

Qualifications

  • Bachelor's degree in health administration, business administration, hospital administration, public health or related field required; Master's degree in one of the named fields preferred
    Critical Leadership Competencies
  •  The incumbent must have:

    • Outstanding leadership and interpersonal/relationship skills with the drive and initiative required to implement change at the strategic and operational levels.
      At least 5 years' experience in Medicare Advantage or managed care

    • Demonstrated experience in managing SNP products

    • Strong understanding and/or experience with Managed Long Terms Supports and Services products such as CHC, the Pennsylvania MLTSS program

    • Product development experience

    • Strong oral and written communication skills

    • Excellent analytical, strategic and operational oversight skills.

  •  The following competencies are desired of this individual:

    • A strong balance of strategic and business skills, with a high level of intellectual agility and capacity for original thoughts. 
    • Ability to instill within the organization a rigorous analytical approach to each aspect of their work from performance management and vendor selection to underlying root cause analysis. 
    • A passion and knowledge to inspire others to introduce new perspectives order to find the best solutions and evaluate effectiveness of these initiatives 
    • Willingness to take risks 
    • Emotional intelligence 
    • Exceptional interpersonal skills who can relate well with people at all levels of the organization and demonstrates sensitivity to others 
    • Balanced leadership style that allows for both hands-on and strategic leadership skills, with the ability to lead by example
    • Results-oriented with a bias toward action
    • High standards for self and team. Successfully achieves goals and remains persistent through obstacles 
    • Maturity to stay focused and work well under pressure. 
    • Honed consensus building and relationship development skills.

Salary Range: $0 / hour

Union Position: NA

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