Director, Health Plan Partner Operations

Summary

Join Carrum Health as Director, Health Plan Partner Operations and ensure smooth, scalable implementations, operations, and growth across our portfolio of healthcare ecosystem and health plan partners. Implement new health plan partnerships, establish and maintain integrations and coordinated member experiences, and ensure operational excellence across billing, reporting, and contract management. This highly visible role requires close collaboration with various teams to operationalize all aspects of partnerships. Drive strategy, efficiency, and growth for new and existing health plan partners to deliver value-based care. You will own the day-to-day operations for Carrum’s health plan partners, manage project delivery and implementation of new partnerships, and refine the implementation infrastructure. This role also involves driving measurement and tracking of referrals, establishing reporting data for insights and improvements, and quarterbacking technological integration with health plan partners.

Requirements

• 10+ years of experience in the healthcare industry in health plan project/product management, account management, operations, and/or consulting roles
• Proven track record of managing and growing complex, high-value health plan partnerships, ideally within value-based care or digital health solutions
• Exceptional communication, presentation, and organizational skills, with the ability to engage with and influence stakeholders across all levels, both internally and externally
• Deep understanding of health plan / TPA operations, decision-making processes and strategic priorities
• Highly detailed-oriented, extremely organized and results-driven; exceptional at creating process and structure. Strong operational and reporting prowess
• Strong analytical skills and the ability to use data for storytelling and driving decision-making
• Entrepreneurial spirit; not afraid of ambiguity, ability to innovate, think outside the box, and solve problems creatively and strategically
• Experience working in fast-paced environments with aggressive deadlines and cross-functional collaboration
• Are self-motivated; a go-getter that proactively looks to make things better rather than waiting for marching orders
• Passion about Carrum Health’s mission to make healthcare more affordable and consumer-centric

Responsibilities

• Serve as the day to day operations owner for Carrum’s health plan partners, building strong and lasting relationships based on mutual trust and aligned objectives
• Own the project management delivery and successful implementation of new health plan partnerships, as well as the expansion of existing partnerships
• Refine and iterate our health plan partner implementation infrastructure, including but not limited to implementation playbooks, data and analytics capabilities, reporting standards, and relationship health measurements
• Drive the measurement and tracking of bi-directional referrals between Carrum and our health plan partners
• Establish and analyze reporting data to extract insights and drive improvements to member engagement in an iterative fashion
• Quarterback technological integration with health plan partners to improve the utilization of Carrum’s solution and improve the member experience for those that pass between Carrum and our health plan partners
• Identify opportunities for Carrum’s product roadmap, define requirements, and collaborate on solution design with our Platform Team
• Serve as the quarterback by interfacing with health plan partners and Carrum’s Patient Care Team so both parties are set up for success in easily sending and receiving referrals
• Drive care coordination workflows by balancing multiple stakeholder needs
• Manage the financial aspects of our health plan partnerships including billing and invoicing, and revenue share calculation
• Serve as the liaison to Carrum’s Finance team to ensure accurate and timely payments with respect to our partnerships
• Manage the contractual aspects of our health plan partners including order forms for new employer clients adopting Carrum, and amendments to existing contracts as needed, interfacing with Carrum’s Legal/Contracting department where appropriate

Benefits

• Flexible schedules and remote work
• Chicago and San Francisco offices available
• Self-managed vacation days, within reason
• Paid parental leave
• Health, vision, and dental insurance
• 401K retirement plan
• Stock option plan