Health Plan Associate, Program Management

Role Scope: 

We are looking for a detail oriented, results driven individual who will drive assigned program outcomes from initiation to close-out in a defined timeframe. The Health Plan Associate – Program Management plays a central role in coordinating and monitoring cross-functional projects that span claims, authorizations, pharmacy (Part D), provider network, eligibility/census management, member services, and other Health Plan program management. 

This role focuses on project execution, risk identification, and operational readiness, helping the Health Plan leadership team ensure key initiatives, regulatory deliverables, and performance improvements stay on track across all areas for both current and future Health Plan products. 

• Lead cross-functional healthcare projects and initiatives with varying levels of risk and/or complexity 

• Support Health Plan leadership in driving projects and initiatives that cut across multiple domains (e.g., new vendor implementations, regulatory audits, process standardization, data integrity efforts). 

• Develop, maintain, and monitor project schedules, milestones, and deliverables; track dependencies across teams. 

• Prepare resource and timeline estimates, proactively identifying risks and constraints; recommend adjustments to keep work on target. 

• Coordinate and facilitate project meetings with internal stakeholders and external partners; create and distribute agendas, meeting minutes, and status reports. 

• Follow up with responsible parties to ensure timely completion of open items and escalation of barriers. 

• Lead operational oversight and process-improvement processes for the Health Plan function including:  

• Establish and maintain end-to-end work plan for Health Plan operations from enrollment and authorizations through claims, pharmacy, and ongoing network performance management, identifying points of risk or inefficiency. 

• Partner with subject-matter experts (e.g., Claims, Compliance, Provider Network, Data & Analytics) to document processes and design improvements aligned to regulatory and organizational goals. 

• Track and reconcile project outcomes with operational metrics (e.g., timeliness, accuracy, compliance adherence). 

• Establish process and support reporting and communications across the Health Plan function: 

• Coordinates and facilitates both internal and external meetings.  

• Creates and publishes agendas, meeting minutes, and necessary documentation.  

• Monitors and controls all aspects of the project by measuring progress and correcting course when project goes beyond scope or is not meeting goals and objectives. Escalates issues appropriately and timely to Health Plan leadership when necessary to remove barriers and drive forward motion of projects.  

Qualifications 

• Aligns with our purpose and values and is excited about living those out in daily practice. 

• 2-4 years of demonstrated experience, knowledge, and a track record in project management techniques, concepts, principles, and standards. Specific healthcare and/or health plan experience required. 

• Excellent written and verbal communication skills and the ability to effectively communicate at all levels internally and externally to establish credibility on project teams. 

• Can skillfully navigate multiple external systems including those operated by Medicare and Medicaid 

• High proficiency with general Microsoft applications, including Share Point as well as Smartsheet's 

• Ability to forecast project challenges and define solutions to maintain compliance with policies and procedures, quality, and schedule. 

• Must have reliable access to printing resource 

Nice to have: 

• Prior experience in PACE 

Compensation:  

We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for medical/dental/vision insurance, short and long-term disability, life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays. The expected salary range for this position is $ 67,000 – $77,000 and is bonus eligible. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location. 

How Habitat Health supports you: 

• Medical, Dental, and Vision plans with competitive coverage for employees and dependents 

• Health Savings Account with employer contribution 

• Flexible Spending Account 

• 12 weeks of fully paid Parental Leave for birthing and non-birthing parents 

• 401k with match 

• CME and License Reimbursements for clinical team members 

• Short and Long Term Disability 

• Voluntary Life Insurance 

• Paid Vacation Time 

• Paid Sick Time 

• 10 company holidays 

• Employee Assistance Program with access to mental health programs, legal and financial support, and much more! 

 

Vaccination Policy, including COVID-19 

At Habitat Health, we aim to provide safe and high-quality care to our participants. To achieve this, please note that we have vaccination policies to keep both our team members and participants safe. For covid and flu, we require either proof of vaccination or declination form and required masking while in participant locations as a safe as an essential requirement of this role.  Requests for reasonable accommodations due to an applicant’s disability or sincerely held religious beliefs will be considered and may be granted based upon review. We also require that team members adhere to all infection control, PPE standards and vaccination requirements related to specific roles and locations as a condition of employment. 

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