AVP Health Plan Applications

Job Details

Job Description

Summary
The Associate Vice President (AVP) provides leadership to define and maintain the long-term Health Plan System (HPS) platform strategy for Jefferson Health Plans (JHP) in alignment with strategic objectives. This role requires expertise in platform roadmap development vendor and software capability evaluation enterprise architecture and IT standards and best practices. The AVP leads teams to design develop and maintain software solutions and applications that support health plan operations leveraging methodologies like ITIL for quality processes and problem management. Responsibilities include managing applications related to claims processing member enrollment provider management and compliance with healthcare regulations while enhancing operational efficiency and user experience. The position also oversees application testing deployment maintenance and evolution through issue resolution and system enhancements.

Job Duties

• Support the implementation of the health plan application strategy ensuring alignment with organizational objectives and compliance standards.
• Oversee day-to-day operations of core health plan systems including claims enrollment and provider management ensuring reliability and efficiency.
• Lead projects related to upgrades integrations and enhancements of health plan applications applying effective change management practices.
• Work closely with business units to gather requirements translate them into technical solutions and ensure successful delivery of application functionality.
• Manage relationships with technology vendors and supervise internal teams to maintain service levels resolve issues and drive continuous improvement.

Minimum Qualifications

• Bachelors Degree
• 15 years
• Knowledge and leadership experience in delivery methods including Agile and ITIL

Physical Demands
Lift and carry 25 lbs. frequent sitting/standing frequent keyboard use *patient care providers may be required to perform activities specific to their role including kneeling bending squatting and performing CPR.

Job Description Disclaimer: This position description provides the major duties/responsibilities requirements and working conditions for the position. It is intended to be an accurate reflection of the current position however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.

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Primary Location Address

Nationally ranked Jefferson which is principally located in the greater Philadelphia region Lehigh Valley and Northeastern Pennsylvania and southern New Jersey is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65000 people strong dedicated to providing the highest-quality compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrows professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic clinical and applied research. Thomas Jefferson University home of Sidney Kimmel Medical College Jefferson College of Nursing and the Kanbar College of Design Engineering and Commerce dates back to 1824 and today comprises 10 colleges and three schools offering 200 undergraduate and graduate programs to more than 8300 students. Jefferson Health nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age race color religion creed sexual orientation gender gender identity marital status pregnancy national origin ancestry citizenship military status veteran status handicap or disability or any other protected group or status.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues including medical (including prescription) supplemental insurance dental vision life and AD&D insurance short- and long-term disability flexible spending accounts retirement plans tuition assistance as well as voluntary benefits which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues including those who work less than part-time(including per diemcolleagues adjunct faculty and Jeff Temps) have access to medical (including prescription) insurance.

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