Director, Enterprise Applications

🕒 Outubro 30

🦞 Maine – Remoto

🦞 Maine – Remote

💵 $165.546 - $204.499 / ano

⏰ Tempo Integral

🔴 Especialista

👔 Diretor

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Martin's Point Health Care

SiteLinkedInTodas as Vagas

501 - 1000 funcionários

🛡️ Seguros

📦 Logística

💼 Consultoria

Insurance • Logistics • Consulting

A Martin's Point Health Care é uma organização de saúde comprometida em servir suas comunidades locais com serviços de cuidados primários e especializados de alta qualidade. A organização dá ênfase à criação de uma cultura de trabalho positiva, reconhecendo as contribuições dos funcionários e promovendo a diversidade no local de trabalho. A Martin's Point Health Care oferece uma variedade de oportunidades de carreira em diversos departamentos, desde prestadores de serviços de saúde até funções corporativas, e apoia o crescimento dos funcionários por meio de uma remuneração competitiva, programas de desenvolvimento e benefícios generosos. Além disso, a empresa é reconhecida por seus esforços de impacto comunitário, arrecadando fundos significativos para organizações comunitárias e incentivando o voluntariado dos funcionários.

Descrição

• Leads and transforms the Health Plan Applications (HPA) teams into a single, integrated function with clear IT and business ownership, defined roles, and a sustainable operating model for core system configuration • Drives quality, timely system configuration and maintenance of core health plan systems, including QNXT, care management, and enrollment systems • Oversees, develops, and maintains documentation for claims and benefit configuration processes and procedures with appropriate controls, reporting, and quality assurance • Develops robust testing protocols and supports regular audits and quality checks to ensure configuration accuracy, data accuracy, and system performance • Leads the Application Development team in designing, building, and supporting custom applications and system integrations using SDLC, DevOps, and secure development standards • Provides leadership for the Enterprise Salesforce/CRM platform, including platform ownership, administration, release management, and applications support • Partners with Enterprise Architecture to align application solutions with enterprise standards, technology roadmap, integration, and data strategies • Develops work intake mechanisms and tools to manage ticket inventory, prioritize backlog, and assess work types • Delivers vendor oversight to optimize system processing and pursue new vendor opportunities, including RFI/RFP processes • Collaborates with business, Operations, Data & Analytics, and IT teams on system and operational readiness for fixes, configuration, and project rollouts • Coordinates with infrastructure and integration teams on system upgrades, enhancements, integration updates, and file loads • Manages the Enterprise Applications budget, staffing plan, and vendor spend; tracks performance against key metrics and service levels • Demonstrates the organization’s mission, vision, and core values

🎯 Requisitos

• Bachelor's degree required • 10+ years health plan or healthcare information technology experience, including 5+ years leading application, configuration, or development teams required • Experience managing vended core system applications required • Demonstrated experience leading organizational change and transforming team operating models required • Experience with test plan development, strategy, and execution required • In compliance with MPHC’s Department of Defense contract, all persons hired for this position will need to verify their U.S. citizenship and complete the required employment eligibility verification upon hire • Master's in Business Administration, Information Systems, or comparable advanced degree strongly preferred • Project management (PMP), Agile/SAFe, ITIL, or Salesforce certification preferred • Experience with Cognizant (TriZetto) QNXT configuration, administration, or implementation strongly preferred • Experience leading application development teams (custom development, integrations, SDLC) preferred • Familiarity with Salesforce or other CRM platforms preferred • Experience supporting Medicare Advantage and/or TRICARE lines of business preferred • Knowledge of CMS interoperability requirements (e.g., CMS-0057-F) and healthcare data standards (HL7 FHIR, X12 EDI) preferred • Knowledge of Agile delivery practices and IT service management (ITSM) preferred • Proficiency with work management and ticketing tools (e.g., Jira, ServiceNow, Azure DevOps) preferred • Knowledge of reimbursement agreements as well as claims and billing practices that impact cost and utilization data • Knowledge of industry standards for claims and enrollment configuration, reporting and analysis • Knowledge of benefit coverage and servicing members, providers, and the DoD, CMS/ Medicare Advantage, and ME state insurance coverage • Knowledge of managed care computer systems, features, and reporting • Excellent workflow and inventory management skills • Demonstrated interpersonal, communications, operational, team building, and quality improvement skills • Strong leadership, coaching and change management skills • Ability to communicate effectively with executive leadership and translate business needs into technology solutions • Demonstrates an understanding of and alignment with Martin’s Point Values • Develops and maintains positive, effective working relationships with colleagues, vendors, and other internal and external customers • Excellent problem solving, quantitative and analytical skills with the ability to assess performance against metrics • In-depth technical knowledge and ability to learn new technologies; knowledge of the Software Development Life Cycle (SDLC) • Ability to manage, organize, and prioritize workload in a timely accurate manner • Ability to manage multiple competing demands and function independently • Critical thinking: can identify root causes and implement short- and long-term sustainable solutions • This position is not eligible for immigration sponsorship

🏖️ Benefícios

• medical insurance • dental insurance • vision insurance • retirement savings with employer contributions • paid time off • volunteer time off • pie day • other employee benefits • additional compensation, such as incentive or commission-based programs, where applicable and subject to the terms of the applicable plan

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