Insurance Program Manager Jobs in Tallahassee, FL

1. CONTRACTOR QUALIFICATIONS AND EXPERIENCE
1.1. As noted in SOW26-076, the selected Contractor must possess the following qualifications and experience:
1.1.1. A minimum of 8 years working with the Department's tobacco systems, other tobacco prevention reporting/information systems, or other community activity tracking systems.
1.2. Contractor staff assigned to this agreement must possess the following minimum qualifications and experience:
1.2.1. A minimum of 25 years of experience in collaboration with health care providers including hospitals, Federally Qualified Health Centers (FQHCs), free and charitable clinics, behavioral health substance abuse treatment centers, health insurance plans provider groups, large physician organizations, and accountable care organizations.
1.2.2. A minimum of 20 years of experience with coordinating with local, state, and federal organizations to facilitate systems change within health systems.
1.2.3. A minimum of 10 years of experience with health systems including coordination, facilitation, and implementation of various information technology solutions.
1.2.4. A minimum of 10 years of experience with facilitating training efforts in health systems change.
1.2.5. A minimum of 20 years of experience with facilitating systems change activities and efforts.
1.2.6. A minimum of 10 years of experience with financial management related to health care systems.
1.2.7. A minimum of 3 years of experience with health care and cessation evaluation findings, implementation of evaluation findings into system change efforts.
1.2.8. A minimum of 10 years of experience with health plans and health plan providers.
1.2.9. A minimum of 25 years of experience with health system types and principles of health systems change.
1.2.10. A minimum of 10 years of experience with identifying and documenting trends related to national and state health policy initiatives.
1.2.11. A minimum of 15 years of experience with partnership building and relationship management in the health care field.
1.2.12. A minimum of 15 years of experience with program development and process improvement measures.
1.2.13. A minimum of 10 years of experience with strategic planning.
1.2.14. A minimum of 15 years of experience with technology systems and solutions related to health care systems including cessation.
1.2.15. A minimum of 3 years of experience with tobacco cessation initiatives and systems.
1.2.16. A minimum of 10 years of experience in leading enterprise-wide, large and small teams with a focus in healthcare environments.
1.2.17. A minimum of 10 years of experience in project and program management with a focus in healthcare environments and health systems change.
2. CONTRACTOR RESPONSIBILITIES
As noted in SOW26-075, the Contractor will perform the following tasks in the time and manner specified:
2.1. SERVICE TASKS:
7.1.1. Upon Purchase Order (PO) issuance, provide a staff member that meets or exceeds the requirements specified in section 4 to provide Program Manager (2. Manager) services. Notify the Department Contract Manager if there is a vacancy within one business day of the date of the vacancy. Provide a new staff member that meets or exceeds the requirements specified in section 4. to provide Program Manager (2. Manager) services within two weeks of the date of the vacancy.
7.1.2. As directed by the Department, develop Department Cessation program strategy(ies), that support business cases and Department Cessation program and Department BTFF-wide high-level program plans.
7.1.3. As directed by the Department, hold monthly meetings with Department staff, to advise, determine status, and facilitate systems change efforts in local target health systems.
As directed by the Department, hold monthly meetings with leadership and local staff from each Area Health Education Center (AHEC). 7.1.1. program office to advise, determine status, and facilitate systems change efforts in local target health system. Ensure one meeting within three consecutive months is conducted in-person. Document the date and location of each meeting and submit the documentation with the corresponding invoice.
7.1.2. As directed by the Department, participate in calls with the Department's Quitline vendor to determine any cessation, systems change, or AHEC interface issues and work to resolve any related concerns.
7.1.3. As directed by the Department, participate in meetings with Department evaluators of cessation and health systems efforts.
7.1.4. As directed by the Department, incorporate evaluation suggestions and recommendations into system change efforts.
7.1.5. As directed by the Department, coordinate efforts and desired participation of Department's Cessation staff with Department's State and Community Interventions as well as Department Health Communications Sections staff.
7.1.6. As directed by the Department, determine and document any impact on tobacco cessation which may occur due to:
7.1.6.1. The planned Health and Human Services (HHS) reorganization;
7.1.6.2. The health industry associations and alliances such as the Florida Hospital Association (FHA) and the Florida Association of Community Health Centers (FACHA);
7.1.6.3. The professional associations and societies such as the Florida Academy of Family Physicians (FAFP) and the Florida Society of the American College of Osteopathic Family Physicians (FSACOFP); and
7.1.6.4. Voluntary health organizations such as the American Lung Association (Florida Chapter), and the American Heart Association (Florida Chapter).
7.1.7. As directed by the Department, identify, document, and distribute information on trends in national and state health policy which might affect health system financing or operations, specifically those policies which might affect tobacco cessation efforts among health systems.
7.1.8. As directed by the Department, partner and collaborate with Department Cessation program management, other BTFF programs, and senior leadership within the healthcare and business community to communicate program strategy and direction as well as identify and prioritize opportunities for utilizing heath systems change and information technology solutions to achieve the goals of the Department Cessation program and BTFF.
7.1.9. As directed by the Department, develop comprehensive lists of health care systems in Florida including hospitals, FQHCs, free and charitable clinics, behavioral health substance abuse treatment centers, health insurance plan provider groups, large physician organizations, and accountable care organizations. Ensure each list includes at least the following information: the organization's name, address, phone number, website, Electronic Health Record (EHR) vendor, and key personnel, and any other information as specified by the Department. Submit a copy of each list to the Department upon request.
7.1.10. As directed by the Department, collaborate with the health care systems in Florida, identified in Task 5.1.12., that are willing to facilitate systems change within their organizations.
7.1.11. As directed by the Department, assist in identifying health care systems change champions in local health organizations, which include but are limited to: chief executive office, chief operating officer, president of operations, vice president of operations, vice president of nursing, director of nursing, chief medical officer, marketing coordinator, community relations coordinator, outreach coordinator, or other key service line directions such as cancer, cardiovascular, as well as women's health, etc.
7.1.12. As directed by the Department, develop a list of health care provider groups (such as Medicaid Health Plans and Agency for Healthcare Administration (AHCA)) specified geographic areas of operation in Florida. Ensure the list includes, at a minimum, the following: plan name, parent health plan (if applicable), office address, email address, phone number, website, and key personnel, and any other information as specified by the Department. Maintain the list throughout the PO term. Update the list as directed by the Department. Submit the list to the Department upon request.
7.1.13. As directed by the Department, contact the health care provider groups as specified in Task 5.1.15., to determine their willingness to engage in systems change and coordinate systems change activities.
7.1.14. As directed by the Department, develop a list of other health care provider groups (such as commercial, Medicare, or Affordable Care Art exchange-based health plans in Florida. Maintain the list throughout the PO term. As directed by the Department, update the list. Submit the list upon request to the Department.
7.1.15. As directed by the Department, contact the other health care provider groups in Florida identified in Task 5.1.17., to determine their willingness to engage in system changes and coordinate system change activities.
7.1.16. As directed by the Department, coordinate with other local, state, and federal organizations, as necessary, to facilitate systems change within health systems. Organizations will include, but not be limited to, other Florida Department of Health divisions and sections; AHCA; Florida Department of Children and Families (DCF); Florida Department of Elder Affairs (DOEA); HHS and operating divisions including, but not limited to, Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), Health Resources & Services Administration (HRSA), and Substance Abuse and Mental Health Services Administration (SAMHSA).
7.1.17. As directed by Department, contact and coordinate with representatives of major hospital electronic health record vendors in Florida, including but not limited to, Epic, Oracle, Health/Cerner, Meditech, and AllScripts/Veradigm, to facilitate eReferrals from partner organizations.
7.1.18. As directed by the Department, contact and coordinate with representatives of EHR systems, including but not limited to: NexGen, AthenaHealth, and eClinicalWorks, for physician organizations and FQHCs, to facilitate eReferrals from these organizations.
7.1.19. As directed by the Department, meet with Department staff and representatives of AHECs, major hospital systems, physician organizations, and FQHCs to facilitate E-referral as well as electronic health record vendors in Florida.
7.1.20. As directed by the Department, meet with Department staff, representatives of AHECs, as well as other contracted information technology solutions vendors to coordinate, identify, and facilitate change to BTFF related systems and/or solutions including but not limited to TFFACT, E-referral hub/functionality, FCAA system, and the Quitline.
7.1.21. As directed by the Department, direct orientation, training, and mentoring of Department staff including managers and section leads in the principles of health system types and health systems change.
7.1.22. As directed by the Department, coordinate with Department staff to create program and user manuals.
7.1.23. Lead or participate in health systems change trainings for Tobacco Treatment Specialists, as directed by the Department.