Alaffia Health is a high-growth healthtech startup focused on improving the healthcare system through innovative claims operations. The Implementation Project Manager will lead SaaS and services implementations to help health plans reduce improper payments and enhance operational efficiency.
Responsibilities:
- Leading end-to-end implementation projects for Payment Integrity and Utilization Manager offerings, including scoping client requirements, configuring systems, and integrating existing workflows to optimize processing, reduce waste, and enhance compliance
- Partner with our Engineering, Product, and Claims teams to develop detailed project plans, timelines, and budgets, while performing risk assessments to minimize disruptions and ensure on-time delivery
- Coordinating the execution of Payment Integrity and Utilization Management initiatives and strategies to increase speed to value, client satisfaction, and cost-effectiveness
- Facilitating client training sessions, user adoption programs, and knowledge transfer to ensure smooth transitions, including hands-on support for data migration, system testing, and go-live activities
- Monitoring project progress, reporting on key metrics (e.g., ROI, efficiency gains), and resolving issues through proactive problem-solving and escalation when needed
- Ensuring all implementations adhere to healthcare regulations (e.g., HIPAA, CMS guidelines) and align with best practices, while driving continuous improvement based on client feedback and performance data
Requirements:
- Project Management Professional (PMP) certification
- Lean Six Sigma (Green Belt or higher)
- 5+ years of experience in project management
- At least 3 years focused on SaaS and services implementations in healthcare
- Deep knowledge of utilization management processes
- Deep knowledge of payment integrity strategies
- Excellent communication and interpersonal skills
- Proficiency in project management methodologies (e.g., Waterfall, Agile)
- Proficiency in tools such as Microsoft Project, Jira, or Asana
- Strong analytical skills for data-driven decision-making
- Familiarity with payer systems
- Familiarity with health plan workflows
- Familiarity with payment integrity and coding methodologies (e.g., MS DRG, APR DRG)
- Experience with healthcare-specific software (e.g., VMS, RPO systems)