Job Description

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

DIRECTOR, PRODUCT DEVELOPMENT

JOB SUMMARY:

The Director, Product Development will lead our organizations product strategy, development, implementation, and management by driving the success and growth of our organization by overseeing and managing the development of new product lines and existing products. The Director, Product Development will manage the implementation and ongoing synchronization of all Community Health Choice's programs, including regulatory review, program launch, and operational processes. Monitor programs operational performance post launch and collaborate with internal and external stakeholders. Integrate multiple project plans to create cohesive programs with identifiable critical path, task dependencies, project inter-relationships and major milestones, and manage programs project plans, schedules, and resources, ensuring completion within regulatory, scope, budget, time, and quality parameters.

JOB SPECIFICATIONS AND CORE COMPETENCIES:

  • Support leadership of all operational areas as the liaison to state and federal partners related to program readiness reviews, implementation, and ongoing oversight activities; to include STAR+PLUS, STAR, CHIP, Medicare (DSNP), and Marketplace;  Builds consensus across departments during the product development, implementation, and ongoing operations through strong cross-functional relationships to engage internal/external stakeholders and manage program initiatives to foster collaboration among project teams and business unit leaders to eliminate gaps in process design, risk and barriers, and to meet program implementation milestones.
  • Manages all program deliverables through the utilization of matrixed resources, escalates gaps and barriers in implementation and ongoing operational compliance with oversight from Vice-President, Product and Business Development & Sales; Prepare senior management program implementation and operational progress and performance metric reports and coordinate internal communication related to program operations.
  • Serves as industry subject matter expert in the functional areas of all programs covered services in a consultative role that develops business case methodologies for program related initiatives; participates in the development and implementation of business strategy.
  • Proven ability to quickly assimilate information and make informed decisions; logical, analytical thinker with great influencing, written and verbal communication abilities; ability to handle multiple priorities and deal with ambiguity
  • Identify program operational efficiencies to meet regulatory expectations, and develop a ¿best practice¿ approach of the defined operational areas through the assessment of program operational strengths and weaknesses and enhanced operational models
  • Oversees and review post-implementation project reviews to close program projects and to address post implementation program issues, concerns, and improvement


MINIMUM QUALIFICATIONS:

  • Education/Specialized Training/Licensure: Bachelors degree in Healthcare or Business Administration or related field. required. A masters degree in a relevant filed is preferred but not required.
  • Work Experience (Years and Area): 10 years, experience with managed healthcare in STAR+PLUS, STAR, CHIP, Medicare (DSNP), and Marketplace
  • Management Experience (Years and Area): 5 years management experience
  • Software Proficiencies: Microsoft Office (Word, Excel, Outlook)


ADDITIONAL SKILLS: 

  • Strong leadership and team management abilities, with a track record of driving performance and delivering results
  • Excellent strategic thinking and problem solving skills, with the ability to analyze complete problems and develop creative solutions
  • In-depth knowledge of managed care programs, such as STAR+PLUS, STAR, CHIP, Medicare (DSNP), and Marketplace
  • Strong project management skills, including the ability to manage multiple deliverables with competing deadlines
  • Effective communication and presentation skills, with the ability to influence and engage stakeholders at all levels
  • Travel around Houston, surrounding counties and Austin, TX

Application Instructions

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