Under the direction of the Director, Health Care Services (HCS) Business Operations, the Senior Consultant supports the development and implementation of a mid to long-range strategic plan consistent with the goals and operating priorities of the organization. Focus areas include, but are not limited to: HCS systems and vendor implementation, geographic expansion, compliance, medical cost trend and related business process design or redesign. The Senior Consultant is expected to independently develop approaches and work plans. The Sr. Consultant's expertise and scope includes Health Care Services Business Operations (Health Care Services Informatics, Technology and Systems Configuration, Education, and Population Health Programs). The Senior Consultant also collaborates with select Tufts Health Plan Strategy and Product Teams, business stakeholders and vendors to develop and implement strategic projects. The Senior Consultant functions as a senior project manager /advisor on strategic initiatives. The Planner/Senior Consultant supports key steering committees and other strategy teams by preparing and presenting summaries of analyses, project status reports and presentations. The Senior Consultant may also represent Health Care Services Business Operations on corporate agenda projects requiring Health Care Services Business Operations input and subject matter expertise.
* Program implementation: Serve as senior program manager on strategic projects in the HCS Business Operations department as assigned
o Prepare opportunity assessments for submission to the Corporate Agenda Management Committee (CAM).
o Develop project plans and schedules in accordance with THP project management standards
Develop business plans, project charters and work breakdown structures, specifying goals, strategy, governance, staffing, scheduling, identification of risks, contingency plans, and communication plans.
Identify and schedule project deliverables, milestones, and required tasks.
Manage the project execution and coordinate project closeout activities, including transition plans and lessons learned.
Make recommendations for infrastructure, operational metrics and related reporting formats. Guide the design and implementation of key metrics and reporting to support business plans and initiatives
* Training for Clinical Operations and Pharmacy
Lead training team that has responsibility for new hire onboarding, systems training and staff development
Utilize state of the art training methodologies and tools in developing and delivering content
* Strategic analysis: Analyze and evaluate industry and local marketplace dynamics in order to evaluate the current strategic position of Tufts Health Plan in respect to Health Care Services business systems. Identify strategic opportunities, and recommend modifications or proposed strategies and tactics.
o Coordinate the collection of industry intelligence.
o Collaborate with external contacts and participate in senior level strategy teams on corporate strategic initiatives related to Health Care Services business systems
o Identify, research, and evaluate strategic opportunities
o Prepare and present findings and recommendations to the applicable THP committee or team.
o Develop and prepare recommended refinements to strategy/objectives on an as needed basis, but minimally prior to the annual budget process.
* Management/stakeholder communications: Support THP strategy teams by preparing and presenting summaries of analyses conducted, strategic project status reports and presentations to management team and key stakeholders.
* Centralized Regulatory Reporting: Support development of centralized model for regulatory reporting submission
* Planning and design/development: Evaluate and make recommendations to senior leadership regarding the following:
o Evaluate, develop and recommend business process structures, policies and procedures to support the consolidation of enterprise wide clinical business system.
o Develop robust support model accounting for geographic expansion
o Evaluate necessary skill sets, team structure, metrics and productivity model
o Develop vendor relationship model and vendor expense tracking/budgeting procedures
o Develop analysis for evaluating expansion opportunities
o Lead the implementation and change management activities of infrastructure implementation
* Staff management: Responsibility for training team and additional supervisory responsibilities as assigned
* BA, BS in health care or business required.
* Masters in health care or business administration strongly preferred.
* Certification and/or training in project management preferred
* Requires 7 to 10 years of experience in business or managed care environment, of which 3 to 5 years of demonstrated experience occurred within health care consulting, business/strategic planning, and/or project management settings with multidisciplinary teams.
* Must have successfully managed project implementations involving large vendors in matrix management environments.
* Must be highly proficient at leveraging data and content to develop stakeholder presentations for senior level audiences.
* Experience with managing and influencing a diverse group of stakeholders.
* Experience with taking calculated risks while exercising sound judgment and initiative.
* Experience with Medicare, Medicaid, and Commercial health insurance products preferred.
* Proficiency in the MS Office, MS Project, and flowcharting software and business writing is essential.
* Prior experience in operations or IT preferred.
* Must be creative and innovative in researching, analyzing, and summarizing industry trends and new developments.
* Must be comfortable working on developmental projects, which are ambiguous, evolutionary and iterative in nature.
* Must be self-directed, politically astute, and have outstanding interpersonal, teaching, decision-making, and written/oral communication and presentation skills.
* Experience in education or workplace training; working knowledge of industry standard authoring tools and methods of training delivery
* Requires ability to assess all work and prioritize as necessary. Must be highly organized and able to juggle multiple priorities effectively. Must be able to work both autonomously and as a team player.
* Must have strong planning, problem solving, analytic and change management skills.
* Must have critical thinking skills to understand complex implementations and gain depth in understanding subject matter.
* Interacts independently with all levels of Tufts Health Plan management, staff, providers, administrative personnel, and vendors.
* Requires attention to detail to accomplish both the small critical tasks of projects along with having a thorough understanding of project's impact on other departments and implications for the company and provider network.
* Excellent interpersonal, cross-departmental and leadership skills to manage high profile, strategic projects. Must be able to work cooperatively as a team player.
* Must be adaptable to change and ambiguous situations and maintain constructive behavior and performance under stress. Must possess the ability to react quickly and calmly under pressure. Must have resilience and stamina while working through challenging situations.
* Requires high-energy and strong teamwork skills for mobilizing staff around a goal.
* Must be able to exercise appropriate business judgment as necessary.
* Requires the ability to deal with complex situations and individuals while managing multiple priorities.
* Requires a high degree of confidentiality with regard to THP strategies, provider issues, and member issues.
WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS:
* Fast-paced, professional office environment handling multiple demands and pressures.
* Use of telephone and PC required.
CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential. Exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled