Health Plan Manager in Rockville, MD at Booz Allen Hamilton Inc.

Date Posted: 9/10/2018

Job Snapshot

Job Description

Job Number: R0035868

Health Plan Manager

Key Role:

Provide insight into and develop and implement health plan and insurance-based services. Administer the following health plan functions: provider network contracting and reimbursement, revenue and expense modeling, claims processing and analysis, care management and usage practices, medical policy development and review, provider and customer relations and services, member and provider communications, product design, rate build-ups, auditing and fraud detection, and population health analytics and reporting. Work with clients and lead delivery teams that develop, model, or implement health plan functions using best practices from the commercial health plan industry. Work effectively in a team environment to produce deliverables and provide consultative input and facilitation to help a client meet its mission relative to health care coverage. Develop and deploy cost, quality, or member experience solutions while managing a team. Maintain responsibility for managing and growing client relationships.

Basic Qualifications:

-10+ years of experience with health plans, including leading or managing health plan functions in commercial or government sectors

-5+ years of experience with project management, including leading teams to define, plan, and manage complex scope and IT systems from start to finish and keeping projects on schedule, mitigating risks, and ensuring they are within budget and resource constraints

-Experience in collaborating with others to produce both high-level and detailed requirements

-Experience with consulting on or developing cost, quality, or customer experience solutions

-Experience in managing teams and working with clients both remotely and directly

-Experience in working directly with C-suite executives, including developing presentations and delivering high quality project artifacts

-Knowledge of healthcare data analysis

-Knowledge of health plan products and services

-Ability to comprehend and master health plan topics quickly

-MA or MS degree

Additional Qualifications:                                                                 

-Experience with Medicare Advantage and Medicaid Plans, TriCare, or VA Community Care a plus

-Knowledge of the requirements to deliver, build, or deploy health plan functions successfully

-Knowledge of the basic functions of a health plan and how they relate and impact stakeholders

-Ability to work well independently and within a fast-paced, team-oriented environment

-Ability to discuss population health models and approaches a plus

-Possession of excellent oral and written communication skills

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