Jobs at Point32Health

Negotiate, execute, and manage ancillary provider contracts; develop reimbursement strategies and budgets with analytics; identify network gaps and expand provider network; create cost-management programs; mentor and possibly supervise associate contract managers; represent Allied Health Services internally and externally.

The Senior Contract Manager leads contract negotiations with healthcare providers, ensuring compliance with financial and legal guidelines, and manages key stakeholder relationships.

Provide HR shared-services support across the colleague life cycle: handle colleague inquiries, manage case management system, maintain HR data and records, process HR transactions, assist onboarding/offboarding, support colleague relations and training logistics, and identify process improvements to increase operational efficiency.

The Internal Controls Manager leads MAR and SOC reporting programs, ensuring compliance, audit readiness, and collaborating with Finance, IT, and external auditors to uphold control integrity.

Review and manage pharmacy prior authorization requests and coverage determinations, consult with medical directors on complex cases, communicate with members and providers, perform medication management and reconciliation for complex patients, support utilization management policy interpretation, liaise across departments, and participate in quality, risk management, and care coordination activities.

The Sr Business System Analyst will lead business process analysis, gather system requirements, and implement technology solutions while collaborating with various departments and mentoring junior analysts.

The Instructional Design Specialist creates interactive learning materials, manages instructional design projects, consults with stakeholders, evaluates training effectiveness, and fosters strong relationships to enhance organizational learning solutions.

Lead program performance, regulatory readiness, audit response, and quality improvement for SCO Care Management and D-SNP programs. Own KPIs (Stars, HEDIS, MDS), translate regulatory requirements into operations and training, coordinate cross-functional initiatives, manage a team of program managers, and ensure sustainable implementation of system and policy changes.

The Lead Financial Planning Analyst supports expense management, budgeting, financial analysis, and reporting for various operational areas, ensuring effective cost control and strategic recommendations.

The Director of Network and Provider Analytics oversees analytics for provider contracts and network performance, leads teams, and collaborates with various departments to improve healthcare delivery and operational effectiveness.

The Procurement Category Manager manages vendor relationships, contract negotiations, and performance measurements across indirect categories, ensuring optimal value and risk management.

Lead delivery of complex, high-risk Individual and Small Group product programs. Define portfolio strategy and roadmap, manage cross-functional teams and vendors, oversee P&L and financials, ensure operational readiness, and coach product managers to launch and evolve products across regional markets.

As Vice President of Affordability, you will lead the enterprise strategy to reduce the Total Cost of Care, influence senior executives, and collaborate across departments to improve healthcare affordability and performance.

The Program Manager II manages cross-functional projects and initiatives, overseeing operations, policy analysis, stakeholder engagement, and program development, ensuring successful execution and continuous improvement.

The Sr Data Analyst manages data submissions for regulatory compliance, oversees data analytics processes, and collaborates with stakeholders to enhance data quality and reporting.

Lead complex investigations related to fraud, waste, and abuse in healthcare, developing strategies and action plans to prevent future losses. Collaborate with various teams and educate providers on FWA concerns while documenting findings.

The Senior Business Data Analyst handles complex data analyses, collaborates with stakeholders, documents technical specifications, and develops data solutions to meet business objectives, ensuring quality and compliance.

The Senior IT Internal Auditor evaluates internal controls, assists with audits, prepares audit workpapers, and ensures completion of management action plans.

Lead multi-year product strategy and roadmaps for health insurance product lines. Drive product design, enhancements, and discontinuations; lead cross-functional teams; incorporate stakeholder feedback; perform financial modeling and competitive analysis; monitor portfolio performance and recommend course corrections; collaborate on marketing and customer experience; manage vendors and ensure regulatory compliance to meet membership and profitability goals.

Lead multiyear network product strategy and cross-functional teams to design, launch, and optimize health insurance network products. Drive compliance with state and federal regulations, financial modeling, portfolio performance monitoring, stakeholder engagement, vendor management, and go-to-market collateral and training to meet membership, profitability, and operational goals.