Concord, New Hampshire

**Company :**

HM Health Solutions

**Job Description :**

**JOB SUMMARY**

This job will lead large scale projects or a collection of smaller related projects as a program. Incumbent will manage the overall coordination for the different individual projects in the program as well as ensuring that risks and issues are coordinated across the various projects. Will provide mentorship to other team members. May also be engaged in critical efforts to help correct issues with a challenged project or a large scale client engagement. In some cases, the incumbent will be expected to travel to customer sites to help develop project plans and deliver projects. Responsible for the successful completion of the project on time, on budget and with high quality. Programs will be delivered using Agile Methodologies as defined by the Delivery Excellence processes.

HMHS is contractually obligated to provide and maintain a platform that is compliant with all federal, state, regulatory, and BCBSA requirements. To ensure all plans are able to operate in a compliant fashion while on the HMHS platform, it is paramount that there is a centralized team to facilitate and oversee all aspects of mandate project implementation. This role would also be matrixed to the HMHS Compliance team and would report on mandate project status, raising risks, and mitigating partner plan compliance concerns. This role also includes managing all ACA business on the platform, acting in a SME capacity for all aspects of ACA line of business, including production fixes, mandate and non-mandate projects, and assisting B&E in determining appropriate end-to-end technical solutions that are in line with ACA requirements and standards.

Overall responsibilities for Mandates oversight:

+ Engage all partner plans in mandate project and enhancement work where it impacts them

+ Ensure that all required mandate governance rules are followed through project delivery

+ Train HMHS Project Managers (PMs) assigned to mandate projects on the specific mandate delivery requirements

+ Manage compliance escalations within all mandate projects (e.g. Differences in interpretation, compliance go to market date disputes, scope of work differences, etc.)

+ Act as a single point of contact (POC) for HMHS PMs for your portfolio, as well as all partner plans on any questions or concerns relating to mandate delivery

+ Monitor critical dates and communicating with Compliance when they are at risk

+ Partner with HMHS Compliance team to ensure that capabilities being implemented adhere to the ‘minimum necessary’ rule to gain compliance

+ Manage all partner plan escalations throughout the delivery process, in tandem with the project manager

Overall responsibilities for ACA SME:

+ Act in an overarching ACA SME capacity for the EHS platform

+ Become SPOC for all ACA-related issues and production fixes on the platform

+ Work with Blueprint and Estimation on ensuring our technical solutioning for ACA business meet business and compliance needs

+ Act in a consultative role for our Product areas to ensure technical requirements for ACA business are appropriate and meet business needs

+ Review technical ACA guidance to determine possible platform impacts

+ Provide any needed oversight to any ACA-specific projects, mandated or not.



**EDUCATION**

**Required**

+ Bachelor's Degree in Healthcare, Business, Information Technology or related field

**EXPERIENCE**

**Required**

+ 7 years with Project delivery

+ 7 years with Client Relationships

**Preferred**

+ None

**LICENSES or CERTIFICATIONS**

**Required**

+ None

**Preferred**

+ Project Management Professional (PMI)

**SKILLS**

+ Large Scale Program/Project Management Financial Planning and Management Strong Communication skills Problem Management and Resolution Working in a Matrixed Organization Client expectations management

**Language (Other than English):**

None

**Travel Requirement:**

25% - 50%

**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**

**Position Type**

Office-based

Teaches / trains others regularly

Rarely

Travel regularly from the office to various work sites or from site-to-site

Occasionally

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Never

**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._

**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._

_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy._

_Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

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Req ID: J190029

Concord, New Hampshire

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