Director of Benefit Administration
Job Ref: 55356
Department: OFFICE OF THE COO
Location: 160 Water St. #3, New York, NY
Job Type: Regular
Employment Type: Full-Time
Hire In Rate: $140,000.00
Salary Range: $140,000.00 - $160,000.00
MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus’ network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Reporting to the Chief Operating Officer, the Head of Products/Product Senior Director provides the leadership, management, strategy and vision for MetroPlus ’product lines. Ensuring proper operational controls, administrative and reporting procedures and staff operate effectively and efficiently. The Head of Products/Product Senior Director provides overall management and oversight for the product lines of business; including operational performance improvement, competitive market analysis, marketing opportunities, regulatory and compliance adherence, vendor management, State and Federal advocacy. This role makes the Head of Products accountable for achievement of key corporate goals and objectives, thus contributing significantly to fulfillment of the Plan’s mission and vision.
- Recognizes, adopts, and implements operational best practices and metrics to obtain desired strategic and tactical results.
- Provides day to day leadership, directing, aligning and overseeing the Product Teams and provides strategic leadership to existing and developing operations.
- Leads the strategy, development and management of all MetroPlus products, essentially owning the products.
- Coordinates and manages interrelated Plan operations into a seamless matrix collaborating with major product lines: Medicaid, Medicare, Exchange and Commercial.
- Responsible for the effectiveness and measurement of internal and external operations processes and outcomes, ensuring timely reporting.
- Develops innovative and supportable benefits designs and offerings to lead competitiveness in the Market.
- Tracks and coordinates regulatory changes and ensures compliant implementation.
- Ensures the operational integrity of the products by providing oversight through operational reporting.
- Participates in sales negotiations to promote products with prospective clients.
- Tracks and reports on market conditions.
- Performs competitive market analysis.
- Position the products’ competitiveness in the market through advertising and marketing strategy.
- Participates in client and consumer facing role to build product partnerships with community-based organizations.
- Bachelor’s degree from an accredited college or university in an appropriate discipline required.
- Master’s degree in business, healthcare or public administration is strongly preferred.
- Minimum 8 years of product management experience in the healthcare field required.
- Minimum of 5 years of experience at a Health Plan in an operational or marketing role.
- Experience managing teams required.
- Thorough knowledge of management principles and practices, including process and quality improvement methods.
- Broad and deep knowledge of managed care operations, the interconnectivity of diverse and complex functions.
- Demonstrated knowledge and experience overseeing a diverse array of managed care product lines of business.
- Strong qualitative, quantitative and analytical skills, demonstrated by ability to identify and use information and data to set goals and priorities, make decisions and measure performance, while considering competing priorities and other perspectives within and outside the organization.
- Excellent writing and verbal communications skills, characterized by the ability to clearly articulate complex concepts.
- Creativity and resourcefulness demonstrated by ability to a) conceptualize and implement new policies, programs and procedures; b) set priorities for self and others; and c) achieve maximum functioning with available resources.
- Good judgment in a) seeking and using information to support decision-making; b) anticipating the consequences of decisions and actions; c) communicating information; d) interacting constructively with others both within and outside the organization; e) choosing actions that are beneficial to, and consistent with, the mission, goals, culture and style of the organization.
- Ability to take initiative and think independently.
- Must demonstrate understanding and acceptance of the MetroPlus’ Mission, Vision and Values.•
- Results driven
- Business acumen
- Systems orientation
- Process improvement
- Data driven decision making
- Customer focus
- Written/Oral Communication
- Able to work in a fast-paced environment with competing priorities