Project Manager (Federal Healthcare Program)

WINTrio LLC is an 8(a) and HUBZone organization specializing in delivering high-quality technical and professional services to federal and commercial customers. They are seeking an experienced Project Manager to lead a multi-disciplinary team supporting a major federal healthcare program initiative, managing program teams engaged in various tasks including risk-adjustment data validation and legal analyses.

Responsibilities:

• Lead and manage the project from initiation through close-out, coordinating team members across legal, compliance, medical coding, audit, data, IT and support functions
• Manage legal analysis and statutory interpretation efforts and coordinate production of legal recommendations and decision-writing deliverables
• Direct case-management workflows: intake, eligibility, appeals or requests processing, escalation procedures, issue analysis and resolution
• Supervise medical record reviews and medical coding efforts
• Utilize and oversee platforms like Salesforce (or analogous CRM/case management systems) for tracking cases, workflows, escalations and reporting
• Develop and drive program-management best practices: create status reports, risk/issue logs, change-control documentation, resource plans, budget monitoring, and communication plans

Requirements:

• Minimum 5 years of project management experience leading multi-disciplinary teams in a government, healthcare, auditing or appeals environment
• Demonstrated experience with healthcare risk adjustment, provider reimbursement reviews, audit or appeals program management
• Proven legal analysis and decision-writing experience (legal briefs, memoranda or similar)
• Familiarity with Salesforce or other CRM/workflow systems for case and project tracking
• Strong program management skills: schedule/budget oversight, risk/issue management, resource coordination, status reporting
• PMP certification from the Project Management Institute