Program Manager, Federal Plan

Job Summary

Hybrid Work Environment - Must reside in Hawaii

Pay Range : $73,154 - $121,252

Note : Individuals typically begin between the minimum to middle of the pay range

The Federal Plan program manager is responsible for leadership and oversight of all aspects of HMSA's Federal Employees Health Benefit Plan (Federal Plan 87) contract, HMSA's second largest employer group customer.

This person will serve as HMSA's primary liaison with the Office of Personnel Management (OPM) for Federal Plan 87 activities. Responsible for managing and cultivating HMSA's relationship with OPM, and training and mentoring other HMSA employees who must also communicate directly with OPM. Develops and promotes a collaborative partnership between HMSA and OPM through proactive, open, and honest communication that ensures strong mutual understanding, awareness, and support of shared priorities.

Responsible for strategic and tactical planning of HMSA's approach to delivering excellent performance and value for Federal Plan 87 and providing clear leadership, training, and guidance to all HMSA and partner / vendor resources supporting Federal Plan 87. Acts as subject matter expert and will be responsible for project management to include research, analysis and communication efforts necessary to ensure the continued success of the plan. Oversee and complete complex / time sensitive requests and inquiries.

Keeps up to date on the laws, policies, regulations and compliance requirements expected of the contract holder. In addition, there are several differences in how this plan is administered as compared to other HMSA plans. The program manager is responsible for the critical function of overseeing and coordinating all of HMSA's operational and compliance activities for Federal Plan 87, including the many responsibilities related to the annual re-awarding of the contract.

Minimum Qualifications

• Bachelor's degree and five years of related experience in healthcare operations; or equivalent combination of education and experience.
• Two years of experience leading or managing projects.
• Project management skills.
• Intermediate working knowledge in n Microsoft Office applications, includes Outlook, Word, Excel, PowerPoint.

Duties and Responsibilities

Responsible for strategic and tactical planning of HMSA's approach to delivering excellent performance and value for Federal Plan 87 and providing clear leadership, training, guidance, and coordination to all HMSA and partner / vendor resources supporting Federal Plan 87.Responsible for managing and cultivating HMSA's relationship with OPM, and training and mentoring other HMSA employees who must also communicate directly with OPM. Develops and promotes a collaborative partnership between HMSA and OPM through proactive, open, and honest communication that ensures strong mutual understanding, awareness, and support of shared priorities.Responsible for all outgoing correspondence and communications with OPM and advising and coordinating all responses to OPM for any inquiries, issues, and / or requirements that arise.Manages and provides direction on all internal requirements, regulatory, compliance requirements and initiatives related to benefits, contractual obligations, or any activity related to or affecting the Federal Plan.

Manages, leads, and is responsible for the efficient and effective management of the company-wide matrixed effort to both respond to the annual OPM Call Letter (Request for Proposal) and to meet all operational requirements once the contract is secured. This includes coordinating efforts among virtually every major function within the organization and with our partners / vendors.Responsible for all activities related to the research, analysis, and coordination of required plan changes, benefit proposals and changes, rate and financial calculations and adjustments, Federal brochure revisions and updates, and impact to all internal departments.Meets with senior executives and secures their approval of HMSA's bids and also any subsequent commitments and / or responses due to the government. Submits those documents to OPM for their review and approval and responds to any inquiries they may have. Works with appropriate areas including legal on the annual contract review / approval process.Responsible for the accurate and timely implementation of all plan and benefit changes with all affected departments.

Coordinates and oversees various contractual requirements for Federal Plan 87, such as the "Standard Reporting" requirements (HEDIS and NCQA requirements, Performance Standard reports, and Fraud and Abuse semiannual report).

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