Director, Enterprise Applications

🔥 22 hours ago

🦞 Maine – Remote

🦞 Maine – Remote

💵 $165.5k - $204.5k / year

⏰ Full Time

🔴 Lead

👔 Director

👻 Ghost score 0%

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Martin's Point Health Care

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🛡️ Insurance

📦 Logistics

💼 Consulting

Insurance • Logistics • Consulting

Martin's Point Health Care is a healthcare organization committed to serving its local communities through high-quality primary and specialty care services. The organization places a strong emphasis on creating a positive workplace culture, recognizing employee contributions, and fostering workforce diversity. Martin's Point Health Care offers a range of career opportunities across various departments, from healthcare providers to corporate roles, and supports employee growth through competitive compensation, development programs, and generous perks. Additionally, the company is recognized for its community impact efforts, raising significant funds for community organizations and encouraging employee volunteerism.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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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