Senior Manager, Payer Implementation
4 дн. назад
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implementation managementproject coordinationdata exchangeenrollmenteligibility
Senior Manager responsible for leading payer implementation from contract to go-live, coordinating cross-functional efforts, and driving execution in cardiovascular healthcare.
О компании
- Cardiovascular disease remains the leading cause of death in America. At Chamber, we are rebuilding the cardiology system around outcomes rather than volume. We partner with independent cardiologists to help them lead population health efforts in their communities, equipping them with technology, data, and operational tools that translate complex insights into better care for patients.
- Our model brings together clinical expertise, thoughtful design, and a modern operating platform that supports physicians, patients, and payers. By combining innovative AI tools with a commitment to human-centered care, we aim to transform heart health at scale.
Обязанности
- As Senior Payer Implementation Manager, you’ll join payer implementation discussions as they begin and support delivery from signed contract through go-live, turning strategic commitments into successful launches. Reporting to the Head of Implementation & Corporate Initiatives, you’ll own implementation planning, align cross-functional work-streams, and drive day-to-day execution.
- This is an opportunity to bring clarity and momentum to complex projects, including implementations already underway. You’ll coordinate enrollment, eligibility, data exchange, outreach, and clinical operations, assessing progress, identifying gaps, and asking the questions that shape a practical roadmap. Rather than following a fixed playbook, you’ll build implementation plans tailored to each payer partnership and grounded in Chamber’s model.
- In this a hands-on individual contributor role. You’ll lead payer-facing implementation efforts and influence cross-functional execution without direct people-management responsibilities. Your focus will extend through go-live; ongoing account management is owned by a separate team. Contracting, pricing, and payment terms sit with the Head of Implementation. You keep the record on that work, tracking open items, document versions, and decisions, so the implementation plan stays aligned with the contract.
- You work across key departments, and you know enough about each to ask the right questions, spot when two answers conflict, and keep the owners on schedule. Each team makes the calls in its area. You make sure the calls get made, get written down, and get reflected in the plan.
Требования
- 5+ years of experience leading payer implementations, as a vendor to health plans or inside a plan onboarding vendors, including getting data, compliance, legal, marketing, and clinical teams at the payer aligned and moving on the same timeline.
- You’ve built and led a payer implementation plan when scope and requirements were not fully defined, sequencing what could move while terms were still open, rather than only executing an existing plan.
- Comfortable with ambiguity and operating in an environment where standard structure and processes might not exist yet.
- Experience managing several workstreams at once, including data, outreach, and clinical operations, without losing the thread, alignment or momentum.
- Strong written communication and documentation skills, with experience creating clear, accurate payer-facing presentations, meeting summaries, and implementation materials that distinguish agreed decisions from open questions and identify owners and next steps.
- Experience managing cross-functional partnerships through influence rather than direct authority
- Value-based care experience, health plan vendor oversight or delegation requirements, ideally for Medicare Advantage, is a plus.
Условия
- Remote opportunity, based in the United States.
- Candidates must be authorized to work in the United States without sponsorship.
- Occasional travel to client sites.
Другое
- Own day-to-day payer implementation delivery from late-stage contract conversations through go-live, building and maintaining the project plan, coordinating supporting work-streams, and driving open items to resolution.
- Bring structure and momentum to implementations already underway: assess progress, identify unresolved issues, and drive the decisions needed to move forward.
- Establish and lead implementation of work-streams for each payer. The list below shows the typical work-streams and the kind of work each involves.
- Data exchange : own the requirements, file layouts, test files, acceptance criteria, and the validation step before go-live. The data team owns the build.
- Enrollment and eligibility : track the eligibility, in-program, and exclusion rules as they are agreed, and make sure the written definitions match what finance, clinical, and the payer each believe.
- Clinical design: run the sessions, pre-reads, follow-ups, and decision log, and make sure clinical decisions are reflected in data rules and care team workflows. The clinical team owns the content.
- Outreach and marketing : coordinate payer approval of member-facing materials, consent and opt-out handling, and outreach timing.
- Agreements: coordinate with Legal on BAAs, data use agreements, and other payer contracts that support the implementation, tracking status with the payer, and keeping each one on the launch timeline.
- Payer vendor onboarding and compliance : coordinate security questionnaires, delegation assessments, training attestations, exclusion screening, and oversight audit requirements, routing each to the right internal owner.
- Launch readiness : run the readiness review and go/no-go with the payer, lead the post-launch stabilization period, and deliver a documented handoff to the account management team.
- Partner with the Head of Implementation to assess each new payer’s requirements, clarify known information and outstanding questions, and translate those findings into an actionable implementation plan, sequencing what can move now and flagging what depends on open decisions.
- Prepare implementation progress reports against applicable contract commitments and program goals, highlighting launch milestones, open issues, and decisions required before go-live.
- Serve as Chamber’s implementation point of contact with payer partners guiding implementation meetings, setting agendas, and ensuring follow-through on commitments.
- Proactively surface questions, risks, and decisions with the Head of Implementation and other leaders to resolve blockers and protect launch timelines. Route any payer question that touches scope, pricing, or contract terms.
- Prepare clear, polished partner-facing materials, including project plans, presentation decks, meeting notes, and decision logs.
- Keep internal stakeholders and payer partners aligned with thoughtful, concise, and timely implementation updates covering milestone progress, risks, decisions needed, and next steps.
- Partner closely with Clinical, Operations, Finance, Provider Operations, Legal, and other cross-functional teams to align implementation workstreams, clarify responsibilities, and coordinate responses to emerging issues.
- Own Chamber’s payer implementation playbook as the organization scales, capturing repeatable steps, lessons learned, templates, and best practices from implementation work.
- Build and maintain the implementation toolkit: project plan and status templates, meeting notes and trackers, risk and decision logs, a questionnaire response library, a readiness checklist, and the handoff package, working with the Head of Implementation to set the standard.
- Run a lessons learned review after each launch and fold the changes into the playbook before the next implementation starts.
- Establish a clear path forward for an active health plan implementation by building a project plan, documenting open items, and advancing the data, outreach, and clinical operations work-streams.
- Own the project plan, status deck, and trackers by day 60.
- Earn trust and develop relationships with the Head of Implementation and the teams you're coordinating with as the person who owns implementation details.
- Start building the core implementation templates from the active implementation, so the next partner begins with that structure in place.
- Our values guide how we lead, collaborate, and care:
- Low Ego: We stay grounded, curious, and open to feedback.
- Empathy: We build trust through compassion and thoughtful communication.
- Courage: We take action, think critically, and challenge ideas respectfully.
- Ownership: We follow through with integrity and hold ourselves to high standards.
- Grit: We push through ambiguity, move with urgency, and solve problems with horsepower and heart.