• Performance Sustainability Manager

    AmeriHealth Caritas (Washington, DC)


    Job Responsibilities

    The Performance Sustainability Manager (Healthy DC Plan) will report directly to the Director Operations and will drive product performance across key functional areas against established performance metrics.

     

    Work Arrangement

     

    This position is a hybrid position 4 days a week in our D.C. office located at 1201 Maine SW

    Essential Functions

    + Develops and implements performance metrics that enable measurement of progress on internal metrics and regulatory requirements, including call center SLAs, member and provider grievance & appeals, claims timeliness, provider credentialing, UM turnaround times.

    + Responsible to drive product strategy and planning aimed to improve business results based on continuous improvement that is aligned with enterprise strategy. Oversee the progress of Healthy DC Plan initiatives to ensure progress against business goals, identify risks before they become issues.

    + Collaborates with other leaders in the company, including Executive Team members, to identify opportunities for improvement in plan overall performance.

    + Partners with internal stakeholders and work with our vendors to drive towards top performance on metrics.

    + Partners with Business Performance Reporting to support metrics required for business reviews. Coordinates problem resolution efforts with the Medical Affairs and Provider Services departments regarding complaints and grievances pertaining to quality of care or providers.

    + Other duties as assigned.

     

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    Education/Experience:

    + Bachelor’s Degree (Required).

    + Master’s Degree: MBA preferred.

    + 3 or more years Experience leading cross-functional teams and involvement in helping frame, design and execute solutions for challenging enterprise priorities. Experience leading implementation-centric change.

     

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    Other Skills:

    + Experience in payor operations.

    + Ability to manage multiple tasks simultaneously and to proactively assess project status and highlight potential risks.

    + Ability to work effectively with colleagues at all levels, including ability to manage through influence.

    + Excellent presentation skills, including strong verbal and writing capabilities.

    + Self-starter with an entrepreneurial outlook.

    + Team player who manages with courage, flexibility and versatility.

    + Expertise in Tableau for data visualization and dashboard creation.

    + Strong experience in Excel, Power BI, and other data analytics tools.

     

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    Your career starts now. We’re looking for the next generation of health care leaders.

     

    At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

     

    Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

     

    Discover more about us at www.amerihealthcaritas.com .

     

    Our Comprehensive Benefits Package

     

    Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

     

    The range displayed in this job posting reflects the minimum and maximum for new hire salaries for the position in the D.C. office.; Within the range, individual pay is determined by additional factors, including, without limitation, job-related skills, experience, and relevant education, certifications, or training.;;

     

    AmeriHealth Caritas associates are eligible to participate in our annual incentive program and will also receive our benefits package, consisting of medical, vision, dental, life insurance, disability insurance, 401(k), paid time off and more.;;

     

    The targeted hiring range for this role is expected to be between $116,700 and 159,000.;

     

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    As a company, we support internal diversity through:

    Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.