United States · Remote Solely
$70k–$101k/yr
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. J…
Skills: Program Management, Project Management, HR Process Optimization, Change Management, Strategic Thinking
Boston, Massachusetts, United States · Remote OK
$173k–$250k/yr
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. J…
Skills: Clinical Case Review, Utilization Management, Medical Necessity Review, Medical Policy Evaluation, Appeals and Grievances Management
United States · Remote OK
$70k–$101k/yr
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. J…
Skills: Provider Relations, Network Management, Relationship Building, Communication Skills, Analytical Skills
United States · Remote Solely
$64k–$93k/yr
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. J…
Skills: Medical Record Audit, Clinical Documentation Review, CPT Coding, HCPCS Coding, ICD-10 Coding
United States · Hybrid
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. *…
Skills: Clinical Case Review, Utilization Management, Medical Necessity Review, Medical Policy Evaluation, Appeals and Grievances Management
United States · Hybrid
$70k–$101k/yr
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. J…
Skills: Utilization Management, Clinical Judgment, Medical Necessity Determination, Behavioral Health Evaluation, Crisis Intervention
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The HR Program Manager oversees a portfolio of cross-functional HR initiatives and partnerships to achieve sustainable organizational outcomes. This includes designing HR programs, optimizing processes, and ensuring compliance with Medicaid and Medicare contracts.
Requires a Bachelor's degree and at least five years of business experience in a program management capacity, preferably within Human Resources. SHRM-CP certification and experience in the healthcare or managed care industry are preferred.
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 HR Program Manager will play a critical role in advancing programs, projects, BMC (Boston Medical Center) System partnerships, and initiatives at the WellSense Health Plan. Works closely with the VP of Human Resource to oversee a broad portfolio of cross functional programs initiatives across the entire HR organization to ensure the plan achieves measurable and sustainable outcomes. Partners with BMC Compliance, Compensation, Benefits, HR Operations, and HRIS teams to foster blended strategic connections, program management expertise, and the implementing effective structures and guidelines for all centralized and local initiatives. Serves an influential and informal leader to drive results that align with WellSense and BMC objectives.
Our Investment in You:
· Full-time remote work
· Competitive salaries
· Excellent benefits
Key Functions/Responsibilities:
· Program and Project Management:
o Design, implement, and lead various HR programs and projects that support the organization’s strategic objectives at WellSense and BMC.
o Lead HR process optimization and develop/document guidelines to streamline efficiencies and maintain consistency, where applicable.
o Develop clear detailed action plans and monitor progress. Recommend real-time changes and enhancements that drive toward outputs that meet or exceed expected outcomes.
· Collaboration and Coordination:
o Work closely with internal WellSense and BMC HR and Compliance cross-functional teams to identify program requirements and develop effective solutions for adherence.
o Collaborate closely with HR leadership, business partners, and cross-functional leaders to identify pain points, gather requirements, and develop solutions that align with BMC’s and the organization’s objectives.
o Ensure that all employee information in HRIS is submitted timely and accurately.
o Closely partner with Compliance team to ensure that all HR components of WellSense’s Medicaid and Medicare contracts are managed and adhered to.
· Monitoring, Evaluation and compliance:
o Manage/track key deliverables to include process maps and gap analysis, best practice recommendations, draft policy updates, redesign, and automated processes.
o Establish metrics and datasets to monitor and evaluate the effectiveness of all HR programs and projects.
o Develop evaluation mechanisms to ensure programs are effective and meet the needs of the leaders and employees.
o Ensure all HR programs comply with applicable laws, regulations, and company policies.
Supervision Exercised:
· This is an individual contributor role; it does not have direct reports.
Supervision Received:
· General strategic guidance from the VP of Human Resources
Qualifications:
Education Required:
· Bachelor’s Degree in a related field or an equivalent combination of education and experience required.
Experience Required:
· Minimum of (5) five years of business experience operating in program management capacity
· Preferably in a related field of Human Resources
Experience Preferred/Desirable:
· Change management experience.
· Experience in the health care or managed care industry preferred.
Required Licensure, Certification or Conditions of Employment:
· SHRM-CP preferred.
· Successful completion of pre-employment background check
Competencies, Skills, and Attributes:
· Strategic thinker and detail oriented
· Strong project and program management skills, including planning & organization.
· Independent, well-organized, self-starter
· Creativity and imagination in developing effective engagement initiatives and strategies.
· Proficiency and strong command with the Microsoft Office Suite, i.e., Word, Excel, Power Point
· Excellent communication, both written and verbal
· Strong interpersonal and relationship building skills.
· Ability to work effectively with all levels of the organization.
· Ability to set priorities, manage multiple tasks simultaneously and adapt efficiently to change in an extremely fast paced environment.
· Strong ability to define, track, and interpret KPIs and performance metrics to assess initiative progress and impact.
· Familiarity with financial concepts such as ROI, cost benefit analysis, and value realization for strategic initiatives
· Structured problem-solving skills and comfort operating in ambiguity while driving clarity and execution discipline.
Working Conditions and Physical Effort:
· Regular and reliable attendance is an essential function of the position.
· Work is normally performed in a remote office work environment.
· No or limited physical effort required. No or limited exposure to physical risk.
Compensation Range
$69,500 - $101,000
This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, WellSense offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.
Note: This range is based on Boston-area data, and is subject to modification based on geographic location.
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
A health plan that works for you.
A nonprofit health plan serving Medicare, Individual & Family, and Medicaid plan members in Massachusetts & New Hampshire. Founded 25 years ago as Boston Medical Center HealthNet Plan, we provide plans and services that work for our members, no matter their circumstances.
Offices: 100 City Sq, Boston, Massachusetts 02129, US
A health plan that works for you.
A nonprofit health plan serving Medicare, Individual & Family, and Medicaid plan members in Massachusetts & New Hampshire. Founded 25 years ago as Boston Medical Center HealthNet Plan, we provide plans and services that work for our members, no matter their circumstances.
Offices: 100 City Sq, Boston, Massachusetts 02129, US
