Senior Manager - PHA Solutions

About Advantmed

Advantmed is a leading provider of risk adjustment, quality improvement, and value-based solutions to health plans and providers. We drive market-leading performance with integrated technology, service, and program solutions that optimize the risk and quality performance of our partners. Our solutions focus on identifying, managing, and documenting risk and quality performance and the proactive clinical engagement of high acuity populations.

Job Summary

As Senior Manager, PHA Solutions, you will lead projects and initiatives that support the growth and advancement of Prospective Health Assessments (PHA) performed In-Home or via Telehealth.  You will be responsible for evaluating, proposing, initiating, and executing solutions needed by our clients that may not currently be available in our products or services but can be accommodated if we leverage our skills, experience, resources, and commitment. 

The Senior Manager of PHA Solutions will drive strategy and advancements in what PHA is able to do beyond the Product Roadmap to capitalize on emerging opportunities.  This individual will be a Subject Matter Expert (SME) on risk adjustment prospective activities, including member engagement, in-home assessments, and PCP scheduling for Medicare and Commercial ACA lines of business.  Data analytics and operations experience is a plus.  Prior experience with In-Home Assessments or clinical experience is highly desired.  Depending on the company’s revenue growth, this position may also have direct reports and lead a team to achieve these goals in the future.

Essential Duties and Responsibilities

• Serves as the SME for Prospective Health Assessments (PHA), providing knowledge and expertise and acting as a cross-functional liaison between Sales, Client Success, Product, and Operations.
• Provide Sales and Marketing support for PHA, including doing sales presentations, demos, and writing business winning RFP responses.
• Work with Analytics to determine PHA project ROI to develop and advance Advantmed’s PHA value story.
• Provide training and Product Management support for PHA, including development of effective Point of Care offerings.
• Conduct real time competitive market analysis and develop next best solutions that allow Advantmed to win in the marketplace.
• Brainstorm ideas and bring the product vision to life by working collaboratively with other internal teams, and refining and maintaining the product play book for PHA.
• Integrate customer feedback, industry trends and internal feedback to assist in defining the solution roadmap and priorities for product enhancements or new service offerings.
• Serve as business lead for product functional design process, bringing an intimate knowledge of the users and technology.
• Prioritize product features and evaluate the work developed by the product team to ensure delivery and alignment with the organization’s vision.
• Partner with Product, Operations, and Client Success teams to test new offerings with customers and develop business rationales.
• Collaborate with divisional team leaders to find solutions to PHA client issues by leading discovery, analytics, problem solving, and issue resolution, addressing client service escalations timely and effectively.
• Understand PHA data flow and work closely with PHA Operations on issues that impacts client satisfaction and product success.
• Assist with preparation of analytics, metrics, ROI, and strategy for PHA client Quarterly Business Reviews (QBRs) and Annual Business Reviews (ABRs).
• Responsible for the timely completion of assigned OKRs.

Requirements

Qualifications and Experience

• 4+ years working in the health care industry is desired.
• 3+ years of experience in managed care, data analytics, or product operations is desired.
• 2+ years working in a problem-solving environment or within a product management or product operations capacity is desired.
• Candidates with direct operations or in-home assessment management experience and/or a product/sales background are preferred.
• Candidates that have a clinical background as well as experience working in a product/analytics/operations capacity is highly desired.
• Demonstrated ability to solve problems with appropriate and effective solutions.
• Ability to write SQL and perform data analysis is a plus.
• Prior management experience is a plus.
• Excellent communication and presentation skills to lead both internal and external meetings, to assist sales/marketing, or to provide client support.

Benefits

• Health, Dental and Vision coverage
• PTO
• 401k