Program Specialist, Medicare Star Program
Job Description
Who We Are
Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.
We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health.
Job Summary
The Program Specialist, under direction of the VP of Medicare Star Program, plays a vital role in planning, coordinating, and executing programs and initiatives within the organization. This position involves collaborating with various teams and conducting outreaches to provider and members to ensure high quality of care that align with Point32Health’s goals and objectives, ensuring consistent and effective communication, collaboration, and coordination with external and internal stakeholders. Processes business requirements and partner needs for internal communication and smooth operations of the program. Key success factors of the role include tactical problem-solving skills, organizational skills, strong communication and business execution, ability to coordinate multiple workstreams, curiosity about policy implementation, and a commitment to delivering high-quality work products.The Program Specialist will work directly with members and providers, so knowledge of practice and pharmacy operations is preferred.
Job Description
Key Responsibilities/Duties – what you will be doing (top five):
- Program Development: Collaborate with stakeholders to conceptualize, design, and develop new programs or initiatives that support the organization's mission.
- Planning and Execution: Develop comprehensive project plans, timelines, and budgets for programs. Ensure the timely and successful execution of program activities. Identify and execute opportunities for process improvement or enhancements that support departmental goals.
- Stakeholder Engagement: Build and maintain strong relationships with internal and external stakeholders, including team members, partners, and program participants.
- Resource Allocation: Allocate and manage resources efficiently to meet program goals, including personnel, budgets, and materials.
- Monitoring and Evaluation: Continuously assess program effectiveness, gather feedback, and make data-driven recommendations for improvements.
- Reporting: Prepare regular reports on program progress, outcomes, and challenges for presentation to management and stakeholders.
- Compliance: Ensure program activities adhere to relevant regulations, standards, and policies.
- Communication: Communicate program goals, updates, and outcomes effectively to various audiences, both internal and external. Support reporting, scheduling, and organizing meetings, agendas, presentations, and workflows.
- Other projects and duties as assigned.
Qualifications – what you need to perform the job
Certification and Licensure
Education
- Required: (minimum) Bachelor’s degree
- Preferred: Master’s degree
Experience (minimum years required):
- Required: 3-5 years of experience with a proven track record of success in program management or a related role.
- Preferred: Experience working in the nonprofit sector, health care or Managed care.
Skill Requirements
- Ability to take up ambiguous or complex operational problems and facilitate problem-solving effectively using internal resources and processes
- Ability to prioritize, organize and ensure follow through on multiple deliverables, simultaneously
- Ability to work effectively and independently across functions and with people at all levels, including clinicians
- Excellent communication skills, both oral and written. Excellent interpersonal, communication and presentation skills.
- Must project a professional and mature demeanor and accept direction as needed and be comfortable interfacing with senior leaders.
- Strong project management skills and attention to detail
- Ability to work collaboratively in a team and independently as needed.
- Proficiency in Microsoft Office and project management software.
- Knowledge of relevant industry standards and best practices preferred.
Working Conditions and Additional Requirements (include special requirements, e.g., lifting, travel):
- Fast paced office environment handing multiple demands
- Must be able to work under normal office conditions and work from home as required.
- Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
- May be required to work additional hours beyond standard work schedule.
Disclaimer
The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.
Salary Range
$57,028.00 -$85,542.00Compensation & Total Rewards Overview
The annual base salary range provided for this position represents a range of salaries for this role and similar roles across the organization. The actual salary for this position will be determined by several factors, including the scope and complexity of the role; the skills, education, training, credentials, and experience of the candidate; as well as internal equity. As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company’s sole discretion, consistent with the law.
Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:
Medical, dental and vision coverage
Retirement plans
Paid time off
Employer-paid life and disability insurance with additional buy-up coverage options
Tuition program
Well-being benefits
Full suite of benefits to support career development, individual & family health, and financial health
For more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/
We welcome all
All applicants are welcome and will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
Scam Alert: Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact [email protected]
VEVRAA Federal Contractor.
We request Priority Protected Veteran & Disabled Referrals for all of our locations within the state.
Who We Are
Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.
We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health.
Job Summary
The Program Specialist, under direction of the VP of Medicare Star Program, plays a vital role in planning, coordinating, and executing programs and initiatives within the organization. This position involves collaborating with various teams and conducting outreaches to provider and members to ensure high quality of care that align with Point32Health’s goals and objectives, ensuring consistent and effective communication, collaboration, and coordination with external and internal stakeholders. Processes business requirements and partner needs for internal communication and smooth operations of the program. Key success factors of the role include tactical problem-solving skills, organizational skills, strong communication and business execution, ability to coordinate multiple workstreams, curiosity about policy implementation, and a commitment to delivering high-quality work products.The Program Specialist will work directly with members and providers, so knowledge of practice and pharmacy operations is preferred.
Job Description
Key Responsibilities/Duties – what you will be doing (top five):
- Program Development: Collaborate with stakeholders to conceptualize, design, and develop new programs or initiatives that support the organization's mission.
- Planning and Execution: Develop comprehensive project plans, timelines, and budgets for programs. Ensure the timely and successful execution of program activities. Identify and execute opportunities for process improvement or enhancements that support departmental goals.
- Stakeholder Engagement: Build and maintain strong relationships with internal and external stakeholders, including team members, partners, and program participants.
- Resource Allocation: Allocate and manage resources efficiently to meet program goals, including personnel, budgets, and materials.
- Monitoring and Evaluation: Continuously assess program effectiveness, gather feedback, and make data-driven recommendations for improvements.
- Reporting: Prepare regular reports on program progress, outcomes, and challenges for presentation to management and stakeholders.
- Compliance: Ensure program activities adhere to relevant regulations, standards, and policies.
- Communication: Communicate program goals, updates, and outcomes effectively to various audiences, both internal and external. Support reporting, scheduling, and organizing meetings, agendas, presentations, and workflows.
- Other projects and duties as assigned.
Qualifications – what you need to perform the job
Certification and Licensure
Education
- Required: (minimum) Bachelor’s degree
- Preferred: Master’s degree
Experience (minimum years required):
- Required: 3-5 years of experience with a proven track record of success in program management or a related role.
- Preferred: Experience working in the nonprofit sector, health care or Managed care.
Skill Requirements
- Ability to take up ambiguous or complex operational problems and facilitate problem-solving effectively using internal resources and processes
- Ability to prioritize, organize and ensure follow through on multiple deliverables, simultaneously
- Ability to work effectively and independently across functions and with people at all levels, including clinicians
- Excellent communication skills, both oral and written. Excellent interpersonal, communication and presentation skills.
- Must project a professional and mature demeanor and accept direction as needed and be comfortable interfacing with senior leaders.
- Strong project management skills and attention to detail
- Ability to work collaboratively in a team and independently as needed.
- Proficiency in Microsoft Office and project management software.
- Knowledge of relevant industry standards and best practices preferred.
Working Conditions and Additional Requirements (include special requirements, e.g., lifting, travel):
- Fast paced office environment handing multiple demands
- Must be able to work under normal office conditions and work from home as required.
- Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
- May be required to work additional hours beyond standard work schedule.
Disclaimer
The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.
Salary Range
$57,028.00 -$85,542.00Compensation & Total Rewards Overview
The annual base salary range provided for this position represents a range of salaries for this role and similar roles across the organization. The actual salary for this position will be determined by several factors, including the scope and complexity of the role; the skills, education, training, credentials, and experience of the candidate; as well as internal equity. As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company’s sole discretion, consistent with the law.
Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:
Medical, dental and vision coverage
Retirement plans
Paid time off
Employer-paid life and disability insurance with additional buy-up coverage options
Tuition program
Well-being benefits
Full suite of benefits to support career development, individual & family health, and financial health
For more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/
We welcome all
All applicants are welcome and will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
Scam Alert: Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact [email protected]
VEVRAA Federal Contractor.
We request Priority Protected Veteran & Disabled Referrals for all of our locations within the state.
About Point32Health, Inc.
Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier. We enjoy the important work we do every day in service to our members, partners, colleagues and communities.