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Health Plan Associate, Program Management New Remote, California

$67k - $87k

habitathealth.com

Brooklyn, NY
  • Remote job

Remote, California Habitat Health empowers older adults to experiencemore gooddays in their homes and communities. Through the Program of All-Inclusive Care for the Elderly (PACE), we provide comprehensive medical care along with support for daily needs such as meals, transportation, andin ‑ homeassistance. We deliver coordinated clinical and social care in our centers and directly in participants’ homes, creating a fully integrated experience that brings peace of mind and a true sense of belonging. As we expand our scalable, affordable PACE model to meet the growing and complex needs of aging populations, ourmission ‑ drivencare teams continue to help participants live well on their own terms. Habitat Health is supported by leading healthcare organizations and investors including New Enterprise Associates, Kaiser Permanente, and Town Hall Ventures. We are entering a period of significant growth and are looking for exceptional teammates to help us scale a better model of care for older adults. To learn more, visit Role Scope : We are looking for a detail oriented, results driven individual who will drive assigned program outcomes from initiation to close-out in a defined timeframe . The Health Plan Associate – Program Management plays a central role in coordinating and monitoring cross-functional projects that span claims, authorizations, pharmacy (Part D), provider network, eligibility/census management, member services, and other Health Plan program management. This role focuses on project execution, risk identification, and operational readiness, helping the Health Plan leadership team ensure key initiatives, regulatory deliverables, and performance improvements stay on track across all areas for both current and future Health Plan products. Lead cross-functional healthcare projects, initiatives, and operational process improvements for the Health Plan function Drive projects and initiatives that cut across multiple domains (e.g., new vendor implementations, regulatory audits, process standardization, data integrity efforts) and maintain the end-to-end work plan for Health Plan operations — enrollment, authorizations, claims, pharmacy, and network performance — identifying risks, dependencies, and inefficiencies along the way. Develop and maintain project schedules, milestones, and resource/timeline estimates; partner with subject-matter experts (e.g., Claims, Compliance, Provider Network, Data & Analytics) to document processes and design improvements aligned to regulatory and organizational goals. Coordinate and facilitate project meetings with internal stakeholders and external partners, and track outcomes against operational metrics (e.g., timeliness, accuracy, compliance adherence). Follow up with responsible parties to ensure timely completion of open items, correcting course when work goes beyond scope or off-target, and elevate barriers to Health Plan leadership as needed. Own Health Plan regulatory processes and filings, ensuring strict adherence to critical timelines Serve as the primary point of accountability for assigned regulatory filings, reporting submissions, and compliance deliverables, ensuring accuracy and on-time completion. Maintain a master regulatory calendar of response windows, due dates, and filing deadlines, proactively flagging upcoming items well in advance of when they are due. Balance time-sensitive regulatory obligations against day-to-day functions and ongoing projects, escalating potential conflicts early to protect critical due dates. Serve as the Health Plan lead for go-live readiness on new center openings Represent the Health Plan function in go-live planning and readiness activities, ensuring Health Plan requirements, systems, and processes are in place ahead of each new center launch. Partner with cross-functional teams to track go-live readiness milestones, resolve open items, and confirm operational readiness prior to launch. Qualifications Aligns with our purpose and values and is excited about living those out in daily practice. 2-4 years of demonstrated experience, knowledge, and a track record in project management techniques, concepts, principles, and standards. Specific healthcare and/or health plan experience required. Excellent written and verbal communication skills and the ability to effectively communicate at all levels internally and externally to establish credibility on project teams. Can skillfully navigate multiple external systems including those operated by Medicare and Medicaid High proficiency with general Microsoft applications, including Share Point as well as Smartsheet Ability to forecast project challenges and define solutions to maintain compliance with policies and procedures, quality, and schedule. Nice to have: Prior experience in PACE Compensation: The anticipated base salary range for this position is $67,000 - $87,000 annually. This position is also eligible for a target annual bonus and may be eligible for additional incentive compensation, as applicable. The final compensation offered will bedeterminedbased on factors including, but not limited to, the candidate's qualifications, skills, experience, education, certifications, geographical location, and business needs. In addition, this position is eligible for a comprehensive benefits package, including medical, dental, and vision insurance;paid parental leave,short- and long-termdisability coverage; life insurance; flexible spending accounts; a 401(k) savings planthat includes a match; paid time off; and companypaid holidays. To helpmaintaina safe environment for our participants and team members, Habitat Healthmaintainsvaccination and infection control policies applicable to certain roles and work locations. For COVID-19 and influenza, team members who are working in a participant care setting are required to provide either proof of vaccination or a signed declination form and comply with applicable masking requirements while in a care setting to the extent permitted by law in the applicable jurisdiction. Habitat Health will consider requests for reasonable accommodation based on an applicant's disability, medical condition, orsincerely heldreligious belief, practice, or observancein accordance withapplicable law. As a condition of employment, team members are expected to comply with all applicable infection control protocols, personal protective equipment (PPE) requirements, and vaccination requirements associated with their role and work location, and to the extent required by law and as permitted in the applicable jurisdiction. Our Commitment to Equal Opportunity and Inclusion Habitat Health is an Equal Opportunity Employer committed tothe principles of equal opportunity and inclusion.Employment decisions at Habitat Health are based on qualifications, merit, and business needs. We do not discriminate on the basis of race, color, religion, creed, sex, gender (including pregnancy, childbirth, breastfeeding, and related medical conditions), gender identity, gender expression, sexual orientation, marital status, registered domestic partner status, age, national origin, ancestry, citizenship, military or veteran status, physical or mental disability, medical condition, genetic information, reproductive health decision-making, or any other characteristic protected by applicable federal, state, or local law. Habitat Health is committed to the full inclusion of all qualified individuals. Consistent with applicable law, we provide reasonable accommodations to qualified individuals with disabilities and to individuals with religious beliefs, practices, or observances that require accommodation. If you requirea reasonableaccommodation toparticipatein the application or interview process, perform the essential functions of a position, or receive other employment benefits and privileges, please contact us at View email address on click.appcast.io . We encourage individuals from all backgrounds to apply, even if their experience does not align perfectly with every qualification listed. Habitat Healthparticipatesin E-Verify and will provide the federal government with information from your Form I-9 to confirm your authorization to work in the United States. Habitat Health will not request any documentation to confirm your work authorization prior to a job offer being made. However, after a position offer has been accepted, the Company will request an employee to provide evidence of eligibility to work in the United States through the E- Verify or its state-based equivalent. If E-Verify cannot confirm your authorization to work, Habitat Health will provide you with written instructions and an opportunity to contact the Department of Homeland Security (DHS) and/or the Social Security Administration (SSA) to resolve the issue before any adverse employment action is taken, including termination of employment. E-Verify is used only after an applicant has accepted an offer of employment and completedthe FormI-9and to the extentpermittedbyapplicable law. Habitat Health complies with all federal and state employment eligibility verification requirements. #J-18808-Ljbffr habitathealth.com

Vacancy posted 3 days ago
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