Director, Product Data Management and Operations

Director, Product Data Management and Operations

3 days ago Be among the first 25 applicants

Point
32

Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point
32

Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are.

We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.

The Director of Configuration and Operations of the claim adjudication systems drives configuration strategy and execution, ensuring accurate setup of claims adjudication, products, benefits, payment processes and automation of business processes. Leads high-performing teams and oversees vendor partnerships to optimize system capabilities and deliver enhancements aligned with organizational goals. Collaborates with senior leadership and cross‑functional stakeholders to design scalable, cost‑effective solutions that improve operational and compliance.

Serves as a strategic advisor for configuration governance, risk mitigation, and resource planning, reducing administrative costs while enhancing quality and member experience. Champions innovation by envisioning and implementing transformative business processes across the enterprise.

• Hire, manage, and train direct and indirect staff with domain knowledge in configuration related business applications.
• Continuously evaluate system capabilities to meet business needs and facilitate enhancements.
• Implement and maintain business application systems. Coordinate application upgrades, testing, changes, and patching.
• Define and monitor key operational metrics, ensuring transparency through clear communication, and driving organizational improvements.
• Drive operational improvement programs, including ongoing development of a cross‑functional monitoring program and ensure ongoing compliance to regulatory, contract and internal procedures.
• Represent Operations at enterprise‑wide functional areas across forums; communicate and manage plans, status, risk mitigation.
• Proactively work cross‑functionally to identify and manage enterprise‑wide interdependencies.
• Design and implement tactical and operational plans that impact department and related department results.
• Oversee vendor activities, performance, service level requirements, and ongoing relationship building.
• Develop project plans specifying goals, strategy, staffing, scheduling, risks, contingency plans, and allocation of available resources.
• Monitor department performance against goals and targets to ensure timeliness, accuracy, adherence to metrics.
• Persuade and influence internal and external relationships of critical importance to ensure operations and organizational objectives are met.
• Other duties as assigned.

• Required: Bachelor’s degree required or equivalent experience
• Preferred: Master’s degree preferred.

• Required: 10-15 years of relevant experience
• Preferred: 15-20 years of experience.

• Leadership and management skills are necessary.
• Must be able to communicate effectively with all levels of management and work cooperatively as a team member.
• Ability to lead, direct and motivate large teams effectively and manage through influence.
• Superior problem solving and process management skills.
• Ability to prioritize work and operate under very tight deadlines.
• Motivated and flexible, able to work independently.
• Ability to collaborate effectively and regularly with staff at the highest levels of the organization.
• General knowledge of business…