[Hiring] Director, Enterprise Applications @Martin’s Point Health Care

Role Description

The Director, Enterprise Applications, leads the Enterprise Applications organization, including Health Plan Applications (HPA), Enterprise Salesforce/Applications, Application Development, and Enterprise Architecture. The Director's first priority is to unify and transform the HPA teams into a single, integrated function with clear ownership of core system configuration and accuracy, including but not limited to claims, benefits, enrollment and care management systems. The Director provides strategic and operational leadership for the enterprise application portfolio, aligns application configuration, development and architecture with health plan business priorities and regulatory requirements, and ensures teams organize, prioritize and complete work with appropriate oversight controls, reporting and quality assurance in place.

Qualifications

• Bachelor's degree required
• Master's in Business Administration, Information Systems, or comparable advanced degree strongly preferred
• Project management (PMP), Agile/SAFe, ITIL, or Salesforce certification preferred
• 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
• 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

Requirements

• Maintains knowledge and understanding 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
• 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

Benefits

• Comprehensive benefits package including medical, dental, vision
• Retirement savings with employer contributions
• Paid time off (including volunteer time off!)
• Other employee benefits