Job details

Director Business Solution Delivery and Support - Growing Healthcare Company!

Overview:

About us:

Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn.

Brief summary of purpose:

As a direct report to the Sr. Director of Business Solution Delivery and Support, the Director, Business Solution Delivery and Support is responsible for supporting the mission and goals of Fallon Health through the delivery of core business solutions and the management/execution of those solutions with our core administrative platforms. This leader will direct delivery teams (domains) as well as lead enterprise wide program initiatives that support the overall corporate strategy objectives. The Director is accountable for one or more of the main Enrollment, Claims Adjudication, Provider Management, Care Management and Practice Management solutions leveraged by Fallon, along with many of the operational vendor extracts that are executed today. Responsibilities include development of industry standard solutions for all FH constituencies. This role is to provide strategic guidance in the leveraging of our vendor solutions, building an understanding of the vendor roadmaps and translating those in determination of how they support our corporate goals. The Director is responsible for internal and external relationship management, the development of a high performing team and driving a collaborative and service delivery culture through IT.

Responsibilities:

Function as a key, contributing member of the IT management team
Support the IT strategic planning process
Propose initiatives that support the strategic objectives of the larger organization, identifying short and longer-term requirements.
Determine long-term resources (systems, skills needed, capacity planning, etc.) to meet future business needs.
Direct the effective usage and enablement of Fallon’s technology solutions
Build effective vendor relationships and ensure Fallon is maximizing its utilization of solutions
Direct assessment, evaluation and selection of technology solutions as appropriate
Ensure redundant systems are implemented with policies, and procedures for disaster recovery and data archiving to ensure effective availability, protection, and integrity of data assets.
Building high quality well designed solutions that are both scalable to meet the evolving needs of the business as well as easy to maintain
Provide a framework for application lifecycle management within which the service delivery team will operate
Research best practices and innovative strategies.
Act as a senior resource person for team members in all areas of the work.
Serve as point of escalation with internal and external customers as necessary to resolve issues.
Research and promote the use of accepted best practices and innovative strategies.
Work cross-functionally to ensure operations and changes are well integrated.
Proactively seek feedback from other groups on the impact and effectiveness of current and changes to operations.
Implement, manage and refine business processes required to deliver expected business results.
Implement short-term staffing plans to ensure anticipated operational requirements are met. Monitor the workload and adjust staff assignments accordingly.
Ensure team has appropriate resources and highlights areas of need to Sr. Director for resolution.
Ensure the timely and accurate exchange of information/data with relevant stakeholders of the operation.
Monitor the work environment and the business operation. Address concerns that may affect the morale and/or operational effectiveness of the group.
Build collaborative relationships across the organization and with FH customers and business partners
Work with end users to identify, create, and deliver reports according to requirements.
Work with business leads to understand their business strategy, priorities and expectations
Manage business expectations and ensure that the IT delivery is aligned
Collaborate with business leads to prioritize demand to enable optimal delivery of solutions
Proactively communicate with other departments to ensure cross-functional concerns are identified and effectively addressed.
Establish and maintain an open communication channel with staff.
Monitor effectiveness of communication with other groups (internal and external).
Collaborates with Sr. leadership and peers to implement changes as necessary productive exchange of information.
Represent the department as requested.
Regularly analyze and report on the productivity and effectiveness of the operations in comparison to established performance metrics. Identify areas of improvement and recommend resolution.
Reduce the lead time associated with solution delivery through process improvements, and building better solutions
Building high quality well designed solutions that are both scalable to meet the evolving needs of the business as well as easy to maintain
Regularly track group/departmental costs, ensuring these are managed within budget. Employ cost containment measures while retaining quality and efficient operations and a productive, healthy work environment. Anticipate expenses and identify potential budgetary concerns to leadership.
Work cross-functionally to ensure operations and changes are well integrated.
Proactively seek feedback from other groups on the impact and effectiveness of current and changes to operations.
Implement, manage and refine business processes required to deliver expected business results.
Implement short-term staffing plans to ensure anticipated operational requirements are met. Monitor the workload and adjust staff assignments accordingly.
Ensure the timely and accurate exchange of information/data with relevant stakeholders of the operation.
Develop a team of technology experts who understand the business, and can therefore better align solutions with business needs.
Establish, communicate and manage competencies across directs and ensure that they are integrated across the dept.
Establish dept/team goals and training plans that will help to foster a performance driven culture and set high standards for delivery and career/competency development
Mentor and/or provide leadership to directs
Ensure objectives defined across a broader group are integrated and supportive where necessary.
Define roles and accountabilities for staff, within the group and in the context of the broader process/operation in support of cross-functional efforts.
Hire for, develop and recognize the experience and knowledge/skills/abilities required for a successful team.
Develop a succession plan approach across your team (your role and next levels down).
Monitor work of individual staff for efficiency, effectiveness and quality. Provide ongoing
constructive feedback and guidance to staff.
Evaluate staff on achievement of goals and deliverables and assessment of competencies.
Help staff progress in their careers to the benefit of the department and broader organization.
Manage the resolution of performance issues in consultation with Human Resources as appropriate

Qualifications:

4 year degree in Computer Science, Business or related field preferred

12 years+ related experience within IT
7+ years in IT management capacity
2+ years of experience developing technology solutions within the healthcare industry
Experience leading and developing complex program initiatives
Hands-on experience with business and technical requirements gathering and analysis.
Proven experience implementing multi-year project plans driven by complex business strategies.
Strong understanding of SDLC principles and practices.
Demonstrated experience with designing, building, implementing and supporting integrated technology healthcare payer solutions in support of business strategies and capabilities
Knowledge of project management methods and best practices.
Proven project planning and management experience.
Experience in leading diverse teams in the implementation of application solutions
Knowledge of MS Project and portfolio management principles
Experience with responding to, interpreting and developing solutions to support state and federal healthcare mandates and programs and related information requirements (I.e., Affordable Care Act, MA State Chapter 224 Reform)
Experience working directly with business resources in facilitation of business decisions as they relate to technology solutions and plans
Working technical knowledge of current systems software, protocols, and standards
Ability to understand and translate the organization’s business goals and objectives into technology strategies and solutions
Strong understanding of the organization’s goals and objectives
Good knowledge of applicable data privacy practices and laws

IT Management Experience:

Senior IT Management experience in Healthcare (preferred), Insurance or Financial Services
Leading large cross-functional teams
Vendor Management
Broad IT industry network/peers
Systems Strategy Development
IT Governance
Business Relationship Management

Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Fallon Health Vaccination Requirements:

To protect the health and safety of our workforce, members and communities we serve, Fallon Health now requires all employees to disclose COVID-19 vaccination status. As of 2/1/2022 all roles not designated as “Remote” require full COVID-19 vaccination and Fallon Health will obtain the necessary information from candidates prior to employment to ensure compliance. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

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Fallon Health Glassdoor Company Review

3.7