WellSense Health Plan

Develop and maintain clinical analytics tools and dashboards to support healthcare KPIs and Medical Management strategies, collaborating with cross-functional teams and presenting insights to leadership. | Bachelor’s degree, 3+ years of advanced analytics experience using SAS and/or SQL, proficiency in Tableau and Excel, healthcare data analysis experience, strong problem-solving and communication skills. | It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances. Job Summary: WellSense Health Plan is seeking a dedicated and experienced Senior Health Data Analyst to join our team on a full-time, regular basis. The Senior Health Data Analyst is a key member of the team and serves as a strategic partner to various functional areas throughout the organization to meet corporate objectives. Under the leadership and guidance of Senior Director of Clinical, Operational, and Payment Analytics, the analyst will focus on planning, developing and building of analytical tools to further assess and manage healthcare KPIs during key analytic exercises. The ideal candidate will have a strong background in health data analysis, excellent problem-solving skills, and the ability to communicate complex information clearly to stakeholders. Our Investment in You: · Full-time remote work · Competitive salaries · Excellent benefits Key Functions/Responsibilities: · Work closely with the Senior Director of Clinical, Operational, and Payment Analytics to develop, maintain, and leverage a best in class clinical analytics infrastructure to support the Plan’s Medical Management strategy. · Collaborate with cross-functional teams to understand data requirements and ensure the accuracy and integrity of data analysis · Lead the development of critical analytic processes comparing Plan’s performance against benchmarks to determine areas of focus and opportunity and help maintain industry competitiveness and intelligence. · Work closely with supervisor to present data and findings with insights to the clinical leadership teams to help launch performance improvement initiatives. · Work closely with all levels of Medical Management (including Case Management) leadership in determining how operational and clinical data might assist in addressing their needs. · Build and maintain dashboards that are critical to fine tuning operations. · Work closely with stakeholders to develop critical drill downs as needed to support the development of initiatives to target the areas of over-utilization. · Develop and maintain operational dashboards and performance measurement tools, and reports to measure impact of initiatives · Work with internal and external customers to elicit business data requirements; collaborates with data architects and develops code to meet the data needs of all constituents. · Understand processes and workflows within Medical Management Operations, and translate clinical and operational metric needs into business reporting requirements · Coordinate and participate in Medical Management Operations' technical initiatives, including the development of operational reports and technical specifications in support of all aspects of our UM initiatives. · Work to ensure continuous improvement and adoption of data management best practices · Ensuring compliance with data governance and privacy policies Qualifications: Education: · Bachelor’s Degree required Experience: · Experience in healthcare data analysis and reporting is required. · Three or more years conducting advanced analytics using SAS and/or SQL. · Must have deep understanding and hands-on experience with Tableau or other data visualization tools · Excellent problem solving and analytical skills · Self-motivated, takes initiative to identify opportunities for improvement and makes recommendations for improvement · Ability to work independently and collaboratively · Ability to communicate customers about data needs and explaining report methodologies · Working knowledge of utilizing Enterprise Data Warehouse · Ability to think out-of-the-box to handle any challenging and complex request · Experience managing multiple initiatives or projects at a given time · Ability to foster teamwork and positive attitude. Certification or Conditions of Employment: · Pre-employment background check Competencies, Skills, and Attributes: · Advanced SAS and/or SQL programming skills. · Proficient in Microsoft Excel. · Proficient in Tableau (Desktop and Server) · Some knowledge of Python scripting · Strong analytical and problem solving abilities. Ability to use all relevant data to support decision making. · Enjoy analytical challenges in a fast paced environment with strong ability for managing multiple projects simultaneously and meeting deadlines. About WellSense WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees Required Skills Required Experience

Lead and optimize supplier relationships, ensure compliance with healthcare regulations, manage supplier performance and contracts, and support process improvements. | Bachelor’s degree, 8+ years procurement/supply chain or related experience, healthcare regulatory knowledge preferred, strong communication and analytical skills. | Apply now It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances. Job Summary The Supplier Relationship Manager leads efforts in developing, promoting, and facilitating all aspects of the enterprise-wide Supplier Oversight Program and is responsible for delivery of best in class supplier performance management for assigned suppliers and categories of suppliers. Routine activities include but is not limited to: ensuring that supplier relationships are optimized to support WellSense’s corporate strategy; leading collaboration between business leaders and suppliers to drive program optimization; and supporting knowledge exchange to ensure alignment and innovation. Our Investment In You • Full-time remote work • Competitive salaries • Excellent benefits Key Functions/Responsibilities • Coordinate supplier on-boarding and off-boarding by working cross-functionally i.e., legal, compliance, sourcing, and various operational SMEs • Develop and manage a supplier communication plan to ensure program and operational changes are communicated in an effective and timely manner • Facilitate and prepare materials to support supplier annual reviews for various supplier oversight committees and supplier business reviews for select suppliers • Responsible for evaluating and tracking service level agreements against contract requirements and industry benchmarks • Collaborate with business owners and finance departments to track savings and ROI • Ensure that assigned suppliers are compliant with the business and regulatory requirements outlined in the supplier agreements • Distribute regulatory and operational reports to internal stakeholders in accordance with established business rules • Manage escalations for risks & issues for suppliers within scope of responsibility by working with internal stakeholders such as compliance, legal and various SMEs • Support the tracking and monitoring from a compliance perspective suppliers that are delegated key plan functions and are designated as FDR, Material Subcontractors or Subcontracts in accordance with CMS, and state regulations • Monitor supplier’s progress and compliance with any corrective action related to performance deficiencies. When necessary will work with the functional area managers, legal, and the compliance team if other remediation or contractual impacts are required. • Support internal and external audits of assigned suppliers • Collaborate with business owners, sourcing and legal to ensure change orders, change requests and contract amendments are appropriately documented and executed in a timely manner • Collaborate with finance, sourcing, and business operations to ensure timely disbursement of payables as per contract terms. • Support process re-design and process improvement initiatives • Provide input into new program or product operational readiness plans • Plan, schedule and track supplier relationship management activities using appropriate tools • Support promotion and management of WellSense supplier diversity program • Performs other duties as assigned. Additional Minimum Requirements For Level II • Drive supplier oversight committee activities • Lead the gathering and analysis of industry and supplier trends to provide stakeholders with market intelligence regarding opportunities, innovations and potential competitive advantages • Support supplier risk categorization activities • Drive development and optimization of ongoing status reports regarding the activities, outcomes, and program details of the supplier oversight program • Collaborate with business owners, actuarial and finance to draft and implement new program savings and ROI tracking methodologies • Take a leadership role in developing cost modeling and benchmarking to measure innovation and continuous improvement opportunities proposed by suppliers that contribute to new solutions or improvements • Support identification, development and tracking of new KPI's for suppliers to ensure optimal support and minimize risk to WellSense • Manage and influence supplier contract management processes for suppliers to ensure timely execution of contract reviews and approvals Additional Minimum Requirements For Senior • Develop deep expertise in assigned categories • Assist with the development of supplier relationship governance models, policies and processes • Be an ambassador to the business groups to inform and educate, and to improve acumen and execution of supplier relationship management practices • Identify and influence synergies across the organization by managing stakeholder relationships internally and externally with suppliers • Drive strategic and operational oversight to ensure that business process operations suppliers with offshore teams are effectively managed and are performing in compliance with WellSense business rules and regulatory requirements • Acts as a mentor to less experienced colleagues Supervision Exercised • Capable of managing 10-15 FTEs on project teams Supervision Received • General direction received weekly Qualifications Education Required: • Bachelor’s degree required Education Preferred • Master’s degree in a related field preferred. Experience Required • Supplier Relationship Manager Senior would have a Bachelor's degree in business or supply chain management, or related field and 8+ year’s procurement/supply chain management or related field. • Healthcare related experience preferred • Working knowledge of regulatory requirements in a healthcare environment (FDRs, CMS, NCQA, URAC, etc.) preferred • Experience in CMS Medicare products, Medicaid, or QHP preferred • Familiarity with program design and management desired • Experience with project management desired Required Licensure, Certification Or Conditions Of Employment • Successful completion of pre-employment background check Competencies, Skills, And Attributes • General knowledge of Healthcare Operations and Managed Care required • Conflict management and team building • Excellent relationship management, problem resolution, and service excellence skills. • Analytical and data experience required • Effective collaborative and proven process improvement skills • Strong oral and written communication skills • Ability to interact within all levels of the organization • A strong working knowledge of Microsoft Office products • Demonstrated ability to successfully plan, organize and manage projects • SharePoint, Visio, MS Project skills preferred Working Conditions And Physical Effort • Regular and reliable attendance is an essential function of the position. • Work is normally performed in a typical interior/office work environment. • No or very limited physical effort required. No or very limited exposure to physical risk. • Remote worker arrangement option available. About WellSense WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees Apply now

Develop and implement strategic sourcing and contracting strategies for indirect spend categories, lead supplier negotiations, manage contracts, and build relationships with internal stakeholders and suppliers. | Bachelor’s degree with 7+ years of sourcing and contracting experience, strong leadership and project management skills, knowledge of indirect spend categories, and preferred healthcare regulatory experience. | Apply now It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances. Job Summary The Strategic Sourcing Manager II is responsible for the delivery of best-in-class strategic sourcing, contract management and negotiation. Develop category strategies for complex, indirect spend categories in area(s) of responsibility and serve as the primary contact for business customers. Drive effective, fact-based group decisions that have significant operational or financial impact. Build and manage relationships with internal customers, contribute to savings opportunities, ensure regulatory compliance, and mitigate company risk. The ideal candidate will be a self-starter, and thrive in rapidly changing, delivery-focused environments. Our Investment In You • Full-time remote work • Competitive salaries • Excellent benefits Key Functions/Responsibilities • Develop sustainable strategies for moderately complex categories that include spend analysis, market and geographic considerations, and strategic importance, etc. • Apply in-depth knowledge to solve broad issues that are complex in scope and establish medium to long- range plans. • Recommend and implement sourcing, contracting and supplier management policies and procedures that provide for financial strength of the company and asset security. • Drive continuous improvement in all aspects of the procurement process including the evaluation of existing contracts for savings opportunities. • Lead favorable results through providing leadership to the function. • Develop sustainable sourcing strategies for assigned spend categories by considering spend profiles, market and geographic considerations, WellSense’s strategic objectives, etc. • Maintain contracting and compliance data integrity within the contract management systems. • Lead business owners through the supplier selection, procurement, and contracting process to ensure that contracts produce value in alignment with WellSense’s objectives. • Negotiate and manage contracts moderate in complexity for assigned commodities ensuring the relentless pursuit of cost savings and favorable terms. • Prepare and present contract executive summaries and obtain contract approvals in accordance with governance policies. • Create, manage and promote sound relationships with strategic suppliers and internal business partners. • Partner with Supplier Relationship Managers and Operations Managers as needed to resolve supplier issues. Supervision Exercised • None Supervision Received • General direction received weekly Qualifications Education: • Bachelor’s degree required Preferred/Desirable • Master’s degree in a related field preferred. Experience • The Strategic Sourcing Manager II: Bachelor’s degree in business, supply chain management, or related field and 7 + years sourcing and contracting experience or related field. • Healthcare related experience preferred • Working knowledge of regulatory requirements in a healthcare environment (FDRs, CMS, NCQA, URAC, etc.) preferred • Experience in CMS Medicare products, Medicaid, or both preferred Certification Or Conditions Of Employment • Pre-employment background check Competencies, Skills, And Attributes • Strong leadership and change management skills • Demonstrated strong experience in leading major sourcing events involving multi-department stakeholders • Strong Project Management skills and experience with the ability to lead and prioritize activities. • In depth knowledge of sourcing and contract fundamentals. • Demonstrated knowledge of indirect spend categories, contracting skills and principles, laws, regulations, and industry standards. • Prior experience in all elements of sourcing and category management for indirect services, including professional services and business process outsourcing. • Experience in the 7-step strategic sourcing process with emphasis in the areas of category strategy development, RFx sourcing processes and contract management. • Prior experience in desired spend categories. • Proven negotiation skills and the ability to apply key sourcing principles. • Effective communication and collaboration skills with a wide variety of stakeholders, including leadership and large groups. • Excellent relationship management, problem resolution, and service excellence skills. • Demonstrated competency in facilitating, leading and influencing decision-making. • Excellent problem solving and risk management skills. • Ability to accomplish results through others by establishing relationships, effective controls and monitoring processes. • Ability to develop and analyze business cases, spend analytics, and financial models. • Ability to translate data into convincing information. • Strong working knowledge of Microsoft Office products. Working Conditions And Physical Effort • Regular and reliable attendance is an essential function of the position. • Work is normally performed in a remote work environment. • No or very limited physical effort required. No or very limited exposure to physical risk. • Limited travel may be required About WellSense WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees Apply now