Manager, Federal Plan Programs

HMSA•Honolulu, HI

19h

About The Position

1. Program and Project Management: Responsible for strategic and tactical planning of HMSA's approach to delivering excellent performance and value for Federal Plan 87/Postal Plan and providing clear leadership, training, guidance, and coordination to all HMSA and partner/vendor resources supporting Federal Plan 87/Postal Plan. Responsible for managing and cultivating HMSA's relationship with OPM, and training and mentoring other HMSA employees who must also communicate directly with OPM. Develops and promotes a collaborative partnership between HMSA and OPM through proactive, open, and honest communication that ensures strong mutual understanding, awareness, and support of shared priorities. Responsible for all outgoing correspondence and communications with OPM and advising and coordinating all responses to OPM for any inquiries, issues, and/or requirements that arise. Manages and provides direction on all internal requirements, regulatory, compliance requirements and initiatives related to benefits, contractual obligations, or any activity related to or affecting these Federal Plans. 2. Annual Call Letter & Renewal: Manages, leads, and is responsible for the efficient and effective management of the company-wide matrixed effort to both respond to the annual OPM Call Letter (Request for Proposal) and to meet all operational requirements once the contract is secured. This includes coordinating efforts among virtually every major function within the organization and with our partners/vendors. Responsible for all activities related to the research, analysis, and coordination of required plan changes, benefit proposals and changes, rate and financial calculations and adjustments, Federal brochure revisions and updates, and impact to all internal departments. Meets with senior executives and secures their approval of HMSA's bids and also any subsequent commitments and/or responses due to the government. Submits those documents to OPM for their review and approval and responds to any inquiries they may have. Works with appropriate areas including legal on the annual contract review/approval process. Responsible for the accurate and timely implementation of all plan and benefit changes with all affected departments. 3. Manages and oversees staff; is responsible for their performance and development. Provides employees with guidance and information, while keeping them motivated and engaged. Responsible for all administrative duties such as, training, performance monitoring and reviews and recruitment activities when necessary. 4. Standard Reporting Management & Oversight: Coordinates and oversees various contractual requirements for Federal Plan 87/Postal Plan, such as the "Standard Reporting" requirements (HEDIS and NCQA requirements, Performance Standard reports, and Fraud and Abuse semiannual report). 5. Performs all other miscellaneous responsibilities and duties as assigned or directed.

Requirements

Bachelor's degree and five years of related experience in healthcare operations; or equivalent combination of education and experience.
Two years of experience leading or managing projects.
One year of management/supervisory experience.
Project management skills.
Intermediate working knowledge in Microsoft Office applications, includes Outlook, Word, Excel, PowerPoint.

Responsibilities

Responsible for strategic and tactical planning of HMSA's approach to delivering excellent performance and value for Federal Plan 87/Postal Plan and providing clear leadership, training, guidance, and coordination to all HMSA and partner/vendor resources supporting Federal Plan 87/Postal Plan.
Responsible for managing and cultivating HMSA's relationship with OPM, and training and mentoring other HMSA employees who must also communicate directly with OPM.
Responsible for all outgoing correspondence and communications with OPM and advising and coordinating all responses to OPM for any inquiries, issues, and/or requirements that arise.
Manages and provides direction on all internal requirements, regulatory, compliance requirements and initiatives related to benefits, contractual obligations, or any activity related to or affecting these Federal Plans.
Manages, leads, and is responsible for the efficient and effective management of the company-wide matrixed effort to both respond to the annual OPM Call Letter (Request for Proposal) and to meet all operational requirements once the contract is secured.
Responsible for all activities related to the research, analysis, and coordination of required plan changes, benefit proposals and changes, rate and financial calculations and adjustments, Federal brochure revisions and updates, and impact to all internal departments.
Meets with senior executives and secures their approval of HMSA's bids and also any subsequent commitments and/or responses due to the government.
Responsible for the accurate and timely implementation of all plan and benefit changes with all affected departments.
Manages and oversees staff; is responsible for their performance and development.
Coordinates and oversees various contractual requirements for Federal Plan 87/Postal Plan, such as the "Standard Reporting" requirements (HEDIS and NCQA requirements, Performance Standard reports, and Fraud and Abuse semiannual report).
Performs all other miscellaneous responsibilities and duties as assigned or directed.