The Manager, New Business Implementation will be responsible for supporting new business, from market pre-work through post go live stabilization including planning, direction, and process development for the evaluation and deployment of potential new business and acquisitions. This includes coordination of all new business operations activities related to Enterprise Operations. This position will work closely with the leaders of the functional areas as well as leaders across the organization including Market Entry. Additionally, this position will provide input and decision making for program elements and partnerships in potential new markets.

Core function is to Lead and oversee new business claim related activities including but not limited to the following:

• Act as Point of Contact for the functional area for new business-related activities
• Perform due diligence contract review for business requirements and gap analysis.
• Collaborates with Key Management and Plan associates to lead the system design and implementation of new processes and procedures. Develop and initiate specific contractual program/processes needed that are unique to a new Plan
• Recommends scope of solutions (market or enterprise solutions) to address gaps
• Collaborates in development of and approves business requirements and functional system setup to ensure processes and system design are aligned with new market requirements.
• Drive standardization/best practices in claim implementation activities. Address operational concerns, make recommendations on process, and assist with documentation development to ensure Readiness Review preparation
• Participate in State meetings and Readiness Reviews as a SME
• Develop and inform decisions regarding state specific policies and procedures.
• Maintains and applies subject matter knowledge when providing consultation to other departments during implementations
• Provide oversight for the functional area throughout the new business continuum to troubleshoot issues and drive to resolution. Establishes ongoing metric and process tracking to ensure successful implementations.
• May make decisions on behalf of the functional leaders and appropriately escalates decisions which require leadership involvement.
• Responsible for developing and designing reports to communicate to Senior /Executive Management within EO and across the enterprise. This includes but not limited to work plans, status reports and new business workbook project plans
• Provide guidance to Business Analyst on New Business Implementation team.

Education/ Experience:

• Bachelor’s Degree or Equivalent work experience required
• Ability to lead teams and direct workflow
• Strong written and verbal communication skills (Power Point, Excel, and MS Project, Visio, Word expertise essential)
• Ability to work with cross disciplinary and cross-cultural teams both in team setting and independently
• Ability to travel approximately 25% of the time
• Problem solving and root cause identification skills
• Ability to influence others and move toward a common vision or goal
• Experience with large-scale organizational change
• Minimum of 5 years of Claim Operations Experience required
• 8 to 10 years of relevant healthcare, managed care, or insurance industry environment required.