Location: Mockingbird Towers 4th FLR
PCHP- Parkland Community Health Plan
Primary Purpose
Parkland Community Health Plan's (PCHP's) Manager of IT Application Systems is responsible for the ongoing planning, design, implementation, integration, maintenance, and support of its core business / clinical solutions.
Minimum Specifications
Education
- Associate degree in information systems / computer science or related discipline, or in healthcare related field is required.
- Bachelor's degree in information systems / computer science or related discipline, or in healthcare related field preferred.
Experience
- Eight (8) years of progressive experience implementing and supporting IT applications in healthcare environment.
- Six (6) years of experience managing technical resources in the implementation, integration, and support of complex healthcare IT solutions.
- Four (4) years of experience implementing, integrating, and maintaining Health Plan (Payer) application functions, such as Claims, UM, and Care Management. Specific experience with Texas Medicaid programs is preferred.
- Four (4) years of experience managing complex IT projects that require engagement of both technical and business resources while working with technology solution vendors.
- Specific experience with Cognizant QNXT and Care Advance solutions in a managed-care organization preferred.
Certification/Registration/Licensure
- Project management or Six Sigma certification preferred.
Skills or Special Abilities
- Excellent verbal and written communication skills including the ability to communicate effectively and professionally across disciplines and with a variety of constituents as well as the ability to articulate complex information in understandable terms.
- Demonstrated ability to coach and influence for results.
- Strong interpersonal and conflict resolution skills with the ability to establish and maintain effective working relationships with diverse groups across and beyond the organization.
- Strategic thinking and long-range planning skills with the ability to lead major organizational initiatives, accomplish results, and achieve measurable outcomes or goals.
- Ability to work in challenging situations involving competing interests, and high level-interdisciplinary groups.
- Excellent time management and organizational skills with the ability to manage multiple demands and respond to rapidly changing priorities.
- Strong analytical and problem-solving skills.
- Knowledge of Texas Medicaid (STAR, STAR Kids/CHIP) program, National Committee for Quality Assurance (NCQA), the Uniformed Managed Care Contract, and the Uniform Managed Care Manual.
- Sound business acumen.
- Proficient Microsoft Office and computer skills.
Responsibilities
Operations
- Responsible for the ongoing operation of PCHP's core application systems, including enhancements, upgrades, routine maintenance, and integration with other systems.
- Manages the day-to-day activities of a team of analysts, architects, and other designated resources whose duties support the ongoing operation of PCHP's core application systems, including but not limited to Enrollment, Provider Management, Claims & Encounter Processing, Utilization Management, and Care Management.
- The Manager will assign and monitor work, track incidents and requests, and report status across active implementation projects while giving hands-on direction and guidance to team members.
- Works with stakeholders across organization to optimize the configurations and workflows in support of PCHP's changing business landscape, including adoption of requirements to meet regulatory mandates.
- Documents and presents proposed IT solutions, gathering input and refining final project proposals.
- Serves as SME for system integration requirements both within and outside the organization.
- Works with other IT Teams and PCHP vendors to plan, design, and implement optimal solutions.
- Maintains vendor relationships and holds vendors accountable on contractual deliverables and Service-level agreements.
- Serves as PCHP representative for MCO MIS related activities, ensuring ongoing compliance with HHSC change initiatives and regulatory requirements that impact our PCHP system operations.
- Provides ongoing implementation and support services across adopted application systems, including design and configuration, testing, training, monitoring, and end-user support.
- Works with assigned Project Managers to define and fulfill specific implementation steps relating to design, configuration, testing, and training of new solutions.
- Maintains direct relationships with key application systems vendors, ensuring accountability against contract SLA and other expected deliverables.
Quality
- Integrate health literacy principles into all communication including Members and Providers.
- Support strategies that meet clinical, quality and network improvement goals.
- Promote the use of Health Information Technology to support and monitor the effectiveness of health and social interventions and make data-driven recommendations as needed.
- For staff in clinical roles, foster collaborative relationships with members and/or providers to promote and support evidence-based practices and care coordination.
Regulatory
- Ensures adherence with related regulatory and security requirements.
- Develop processes to maintain compliance with regulatory agencies and accrediting bodies.
- Ensures operations are carried out in compliance with these regulations.
- Works collaboratively with others to validate and sustain compliance with regulatory and accreditation standards.
- Conducts routine compliance audits identifying gaps and implementing remediation plans as necessary.
- Works collaboratively with leadership and/or PCHP Compliance to investigate and respond to matters of concern or alleged violations taking corrective action as necessary.
- Provides timely and accurate responses to requests for information from regulatory agencies and accrediting bodies.
Fiscal Management and Operating Budget
- Operationally responsible for the financial performance of assigned area(s).
- Promote activities to achieve operational efficiency.
- Manage the approved budget through frequent and regular monitoring. Implement written action plans to address variances adjusting strategies as necessary to meet budgetary targets.
- Consider operational outcomes and financial implications when making recommendations to implement new programs or modify current programs.
- Manage staffing levels within established targets.
Talent Management
- Recruit and retain diverse talent with a variety of backgrounds, skills, experiences, and viewpoints that reflect the communities we serve.
- Promote and support a culturally welcoming, inclusive, collaborative, and highly engaged work environment where everyone feels empowered to bring their full, authentic selves to work.
- Accountable for orientation, ongoing education and training, and competency verification for all employees.
- Ensure Human Resource metrics (i.e., retention, vacancy, engagement) meet established targets. Utilize workforce metrics to monitor, identify, and respond to workforce trends.
- Timely completion of employee performance appraisals.
- Conduct regular meetings, inform team of changes in policy or procedure, and provide information regarding overall strategy and direction of the health plan.
- Mentor, coach, and support direct reports with building teamwork, professional development, and education to achieve optimal performance and develop talent.
- Ensure employee engagement survey participation rates and results meet established targets.
- Mandatory requirements are completed timely by employees.
- Required licensure, certification, and/or registry are current and in good standing for all employees.
- Employee performance is monitored and managed. Consult with the Office of Talent Management as appropriate regarding employee performance concerns and disciplinary action.
Professional Accountability
- Acts with the highest integrity and ethical standards while adhering to Parkland's Mission, Vision, and Values.
- Adheres to organizational policies, procedures, and guidelines.
- Completes assigned training, self-appraisal, and annual health requirements timely.
- Adheres to hybrid work schedule requirements.
- Attends required meetings and town halls.
- Recognizes and communicate ethical and legal concerns through the established channels of communication.
- Demonstrates accountability and responsibility by independently completing work, including projects and assignments on time, and providing timely responses to requests for information.
- Maintains confidentiality at all times.
- Performs other work as requested that is reasonably related to the employee's position, qualifications, and competencies.
Requisition ID: 985462
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