Sr. Program Intelligence & Performance Management Consultant

Government Employees Health Association, Inc. (G.E.H.A) is a nonprofit member association that provides health and dental benefits that millions of federal employees and retirees, military retirees and their families have counted on since 1937. Offering one of the largest health and dental benefit provider networks available to federal employees in the United States, G.E.H.A empowers health and wellness by meeting its members where they are, when they need care.

G.E.H.A has one mission: To empower federal workers to be healthy and well.

The Senior Program Intelligence & Performance Management Consultant is a senior individual contributor responsible for defining, owning, and communicating the holistic performance narrative of G.E.H.A's ancillary product portfolio, including dental and vision lines of business. This role sits at the intersection of program strategy, regulatory reporting, and cross-functional data synthesis, translating inputs from the TPA, network, actuarial, finance, and operations teams into decision-ready intelligence for executive leadership and OPM.

The Senior Program Intelligence & Performance Management Consultant defines what program success looks like, establishes the measurement framework to track it, and ensures that G.E.H.A's leadership, and its federal regulator, always has a clear, accurate, and compelling view of program performance. The role partners directly with the product team to support OPM reporting obligations, Corrective Action Plan (CAP) evidence packages (where applicable), regulatory submissions, and builds the analytical foundation for new product launches before they go live.

As the recognized subject matter authority for ancillary program performance measurement, the role operates with limited oversight, exercises independent judgment on matters of significance, and serves as a technical advisor and mentor to other professionals engaged in reporting and analytics work. Recommendations made by this role directly influence executive decisions on program strategy, vendor performance management, and regulatory positioning.

SKILLS

Duties & Responsibilities

Program Performance Framework & Measurement Governance

• Define and own the performance measurement framework for G.E.H.A's ancillary product portfolio — establishing the KPIs, benchmarks, thresholds, and leading indicators that reflect true program health across dental, vision, and future ancillary lines of business.

• Partner with cross-functional teams to ensure the program scorecard aligns with G.E.H.A's strategic priorities and OPM contractual obligations.

• Proactively identify gaps in current measurement, data that G.E.H.A should be tracking but isn't, and work with enterprise Data & Analytics to build those capabilities.

• Establish baseline performance assumptions for any new product lines prior to launch, creating the measurement infrastructure before the first member enrolls.

• Own the definitional standards, calculation methodologies, and data-quality criteria underpinning program metrics, serving as the final authority on how ancillary program performance is measured and reported.

OPM Reporting & Regulatory Support

• Serve as the accountable owner for all OPM-required performance reporting, including annual submissions, CAP evidence packages, mid-year performance updates, and ad hoc OPM data requests.

• Translate program performance data into OPM-ready narrative — clear, accurate, and structured to meet federal regulatory standards and demonstrate program accountability.

• Maintain a regulatory reporting calendar and ensure all submission deadlines are met with sufficient lead time for review and quality assurance.

• Support OPM site visit preparation by assembling performance evidence, identifying potential areas of scrutiny, and recommending proactive disclosures.

• Advise leadership on regulatory reporting risk, including exposure created by data limitations or performance trends, and recommend mitigation strategies in advance of federal review.

Cross-Functional Program Intelligence & Executive Reporting

• Serve as the single point of synthesis across TPA operational reports, CDN network performance data, actuarial financial summaries, enterprise D&A dashboards, and member satisfaction inputs, producing a unified program intelligence view for management and executive leadership.

• Establish a structured cadence for collecting performance inputs from cross-functional partners and hold those partners accountable to timely, accurate data delivery.

• Identify discrepancies, anomalies, risks, and emerging trends across data sources; surface findings with context, implications, and recommended actions.

• Produce decision-ready performance packages, dashboards, and summaries for management and executives on a defined reporting cadence, translating data into clear strategic narrative.

• Support Board-level reporting on dental product performance as requested and ensure reporting demonstrates CAP progress, program accountability, and regulatory compliance throughout the plan year.

Strategic Decision Support & Executive Advisory

• Advise the Director and senior leadership on program performance implications, presenting options, trade-offs, and recommended courses of action on matters affecting program strategy and regulatory standing.

• Develop analytical business cases supporting benefit design changes, vendor performance interventions, and program investment decisions.

• Lead performance deep-dives into emerging issues, determining root cause across operational, network, and financial data, and recommending corrective action to accountable owners.

• Represent the ancillary program in enterprise forums where performance data informs cross-departmental decisions.

Analytical Standards & Mentorship

• Establish and maintain reporting standards, documentation practices, and quality-assurance protocols adopted by others who produce program reporting.

• Coach and review the analytical work of less experienced professionals and cross-functional contributors, elevating the quality and consistency of program reporting enterprise-wide.

• Serve as the escalation point for complex analytical questions regarding ancillary program performance, methodology disputes, and data interpretation.

Knowledge, Skills, and Abilities

• Bachelor's degree in Business Administration, Health Informatics, Public Administration, Statistics, or a related field required, Master's degree preferred.

• Additional years of qualifying relevant work experience may be considered in lieu of formal education.

• Requires a minimum of 7 years of progressive experience in program reporting, performance management, or health plan analytics — with demonstrated ownership of reporting frameworks, not just execution of assigned reports, including at least 2 years in a lead, senior, or principal capacity.

• Exceptional written communication and data storytelling skills — the ability to translate complex, multi-source performance data into clear, compelling narrative for executive and regulatory audiences.

• Strategic analytical mindset: asks 'what should we be measuring and why' before 'how do we pull the data.'

• Strong cross-functional collaboration skills; able to hold partners in finance, actuarial, operations, and D&A accountable to reporting inputs without direct authority.

• High proficiency in Microsoft Office Suite, particularly Excel and PowerPoint; advanced proficiency with Power BI or comparable enterprise visualization platforms required, including data modeling and the design of self-service reporting for executive audiences

• Organized, deadline-driven, and highly reliable — manages multiple concurrent reporting obligations across regulatory, executive, and operational audiences.

• Comfortable operating in a lean, high-accountability team environment where initiative and ownership are expected without prompting.

• Exercises independent judgment on matters of significance, determining methods and approaches without established precedent and operating with limited managerial oversight.

• Demonstrated experience synthesizing data from multiple sources — TPA, network, financial, operational — into cohesive program-level performance narratives.

• Demonstrated experience advising senior leadership on performance matters and influencing decisions through analytical recommendation.

• Experience establishing measurement standards and coaching, mentoring, or elevating the analytical capability of others while maintaining credibility as the program’s technical authority.

Preferred Qualifications

• Direct experience supporting OPM, CMS, or other federal regulatory reporting obligations strongly preferred; FEDVIP or FEHB program experience is a significant advantage.

• Knowledge of federal health benefit program structure, OPM reporting expectations, or government contracting compliance preferred.

• Experience working in or alongside a dental or vision insurance program preferred; familiarity with dental benefit structures, CDT coding, or managed care financial metrics (loss ratio, PMPM, premium rate regions) a strong plus.

Work-at-home requirements

• Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.

• A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.

• Latency (ping) response time lower than 80 ms

• Hotspots, satellite and wireless internet service is NOT allowed for this role.

• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

How we value you

• Competitive pay/salary ranges

• Incentive plan

• Health/Vision/Dental benefits effective day one

• 401(k) retirement plan: company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution

• Robust employee well-being program

• Paid Time Off

• Personal Community Enrichment Time

• Company-provided Basic Life and AD&D

• Company-provided Short-Term & Long-Term Disability

• Tuition Assistance Program

While this is a remote opportunity, at this time G.E.H.A does not hire employees from U.S. territories or the following states: Alaska, Hawaii, California, Washington, Oregon, Colorado, Wyoming, Montana, New York, Connecticut, Vermont, Pennsylvania, Maine.

Please note that the salary information is a general guideline only. G.E.H.A considers factors such as (but not limited to) scope and responsibilities of the position, candidate’s work experience, education/training, key skills, internal peer equity, as well as, market and business considerations when extending an offer.

The target hiring range for this position is $115,702 - $146,370 USD. At G.E.H.A, the current maximum salary for this role is $163,098 USD. While initial compensation may vary based on experience and qualifications, there is a path to work toward this top rate through performance and continued growth within the organization.

G.E.H.A is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. G.E.H.A will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees.

G.E.H.A is headquartered in Lee's Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles.