The Opportunity

The Program Manager for Risk Adjustment & Gaps In Care will work closely with the VP Government Programs, Medicare, Medicaid, and ACA Market Strategy Leaders, and Client Management VPs who have government clients to support the development and execution of revenue retention and growth strategies. 

 

This Program Manager work directly with internal cross-functional leaders from legal, policy, operations, implementation, product management, product marketing, member engagement to ensure risk adjustment and gaps in care programs support the Medicare, Medicaid and AC clients and are successfully generating ROI and value. 

 

The primary goals of this role will be facilitating/developing strong risk adjustment and gaps in care processes supporting successful partnerships with government clients, working internally to identify opportunities for improvement/education and driving positive client relationships with government clients that lead to revenue growth.  Objectives include but are not limited to growth, revenue, retention, client engagement and client management employee engagement.     

 

The program manager may be required to work directly with large health plan clients to solve highly nuanced regulatory and compliance matters, therefore and must have subject matter expertise and experience navigating complex organization and managing the business needs of various stakeholders.  


Responsibilities

  • Operationalize successful risk adjustment and gaps in care programs for all government clients. 
  • Perform quarterly program assessments to ensure contractual and operational compliance to ensure industry best practices are being followed to secure long-term revenue retention and growth. 
  • Based on needs identified by program assessment and Medicare, Medicaid and ACA market leaders, establish and lead internal meetings with Executive Leadership for the purpose of resolving matters impacting government clients, requiring support, education or cross functional coordination; subsequently working with relevant stakeholders, internally and externally to ensure action/resolution. 
  • Understand organizational and departmental goals and objectives specific to growth of government clients and work cross functionally to identify and bring to completion holistic solutions, including but not limited to reporting, audits, and implementation. 
  • Demonstrate strong understanding (perhaps even relationships) with key government clients, understanding their needs, cultivating positive resolution to issues with strong client satisfaction. 
  • Resolving clients’ needs internally through various cross functional departments and providing clients with clear expectations and roadmap delivering value, balancing the needs of the client with the goals of the organization. 
  • Act as a Medicare, Medicaid, and ACA subject matter expert; providing education, being a client facing resource during client meetings, participating in government strategy task forces and working with various departments to identify and bring to fruition improved government strategies. 

Candidate Profile

  • Industry acumen related to risk adjustment and gaps in care processes. 
  • Strong demonstrated knowledge and experience in healthcare, specifically MedicareMedicaid, and ACA, and regulated medical products 
  • Strong critical thinking and analytical skills, and ability to work collaboratively with highly talented professionals 
  • Engaging, highly credible presence and style, confidence in both verbal and written communications with ability to express issues succinctly and make compelling arguments 
  • Diplomacy and ability to manage diverse stakeholders 
  • Independence, resourcefulness, enthusiasm, dedication and desire to learn and teach 
  • Ability to manage multiple projects simultaneously transparently, ensuring that all internal and external stakeholders understand the projects goals and deliverables 
  • Critical thinking to solve strategic problems with excellent analysis and organizational skills 
  • High tolerance for ambiguity, strong work ethic, intellectual curiosity and entrepreneurial approach 
  • Hunger to exceed expectations and a passion to win 

Education Requirements 

  • Bachelor of Arts or Science, Graduate degree preferred 
  • 10+ Years in Healthcare with 5+ years of government experience 
  • Experience interacting with senior level executives 

Why Join Teladoc Health?

A New Category in Healthcare:  Teladoc Health is transforming the healthcare experience and empowering people everywhere to live healthier lives.   

Our Work Truly Matters: Recognized as the world leader in whole-person virtual care, Teladoc Health uses proprietary health signals and personalized interactions to drive better health outcomes across the full continuum of care, at every stage in a person’s health journey.   

Make an Impact: In more than 175 countries and ranked Best in KLAS for Virtual Care Platforms in 2020, Teladoc Health leverages more than a decade of expertise and data-driven insights to meet the growing virtual care needs of consumers and healthcare professionals.   

Focus on PEOPLE:  Teladoc Health has been recognized as a top employer by numerous media and professional organizations. Talented, passionate individuals make the difference, in this fast-moving, collaborative, and inspiring environment.  

Diversity and Inclusion:  At Teladoc Health we believe that personal and professional diversity is the key to innovation. We hire based solely on your strengths and qualifications, and the way in which those strengths can directly contribute to your success in your new position.   

Growth and Innovation:  We’ve already made healthcare yet remain on the threshold of very big things. Come grow with us and support our mission to make a tangible difference in the lives of our Members.  

As an Equal Opportunity Employer, we never have and never will discriminate against any job candidate or employee due to age, race, religion, color, ethnicity, national origin, gender, gender identity/expression, sexual orientation, membership in an employee organization, medical condition, family history, genetic information, veteran status, marital status, parental status or pregnancy (including breastfeeding – we have a mother’s room in both our offices). In our innovative and inclusive workplace, we prohibit discrimination and harassment of any kind.

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