Projé, Inc. is a woman-owned consulting firm providing advisory consulting, project management, and analytical business resources in the health care industry. The Senior Project Manager will manage enterprise-level, cross-functional health insurance projects from inception through implementation, overseeing planning, resources, risks, documentation, stakeholder engagement, testing, training, and post-implementation activities.

Responsibilities:

Use program and project management experience, training, and skills to run successful projects within a Health Insurance Organization
Proven Expertise in many operational areas within a health insurance organization, including claims, billing, provider, enrollment, pharmacy, fulfillment, quality, etc
Engage with multiple stakeholders at all levels of the organization, including executives, directors, managers, and individual contributors
Work with project sponsor(s) and leader(s) to perform planning, including budget and hardware/software estimates, resource estimates and procurement, and implementation timelines for new implementations or enhancements
Collaborate with project sponsor(s) and leader(s) to manage and monitor vendor resources and task assignments as needed
Develop and manage a project schedule throughout the project life cycle, from initiation through post-implementation
Apply formal Change Management processes when substantive modifications affecting the project scope, timeline, or resources/budget are suggested or necessary
Manage project resources, ensure appropriate allocation, alignment to tasks, adherence to the timeline, and conflict resolution
Ensure the project team provides high-quality and cost-effective analytical support services
Facilitate and/or lead process improvement discussions and ensure that current state, desired state, and gaps are well-documented for development of recommendations
Facilitate issue resolution through analysis and collaboration; develop and present recommendations to leadership and negotiate to reach a resolution
Identifies, evaluates, prioritizes, and manages project risks through the application of a Risk Management process designed to minimize, monitor, and control the impact of risks to the project
Organizes and synthesizes large amounts of information for presentation to project sponsor(s), leader(s), and team members through meetings and formal status reporting
Ensures all necessary information is supplied to the Quality Assurance Team for suitable planning and execution of testing
Ensures all necessary information is supplied to the Training Team for planning and execution of staff training
Writes or oversees writing of applicable project documents including project charters, project plan, project schedule, policy and procedures, RACI/project log, business requirements, policies and procedures, and training materials using standard and approved documentation templates. Ensure all project documents are complete, accurate, current, and stored appropriately
Plan, schedule, and facilitate project meetings as needed to effectively manage the project tasks and resources
Develops and publishes detailed implementation plans and schedules
Supports post-implementation stabilization and project closure activities

Requirements:

• Proven success in multiple project implementations within a health insurance company in claims, billing, provider, enrollment, pharmacy, fulfillment, quality, etc., operational areas
• Ability to manage and participate in more than one project of a reasonable size simultaneously
• Able to understand and impartially consider project needs among diverse colleagues in various departments of the same organization
• Ability to produce accurate and precise work, detect and resolve discrepancies, all while meeting deadlines
• History of exemplary relationship management and effective communication with project sponsors, leaders, and team members from across the healthcare organization
• Proficiency with MS Office Suite (Outlook, Word, Excel, PowerPoint), MS Project, and Visio required
• Proficiency with SharePoint, Access, and SQL preferred
• Familiarity with various project methodologies (Waterfall, Agile, SAFe, Hybrid)
• Experience with Epic Tapestry and/or Health Rules Payor claims system and Guiding Care care management systems is a must
• Experience in Medicare Advantage products, Medicaid products and ACA/Healthcare Exchange products is a must
• Bachelor's degree in healthcare administration or related field
• Four (4) years of experience managing projects within a health care organization may be considered in lieu of a bachelor's degree
• Health Plan operations expertise in claims, billing, provider, enrollment, pharmacy, fulfillment, quality, etc
• Five (5) years of experience working within a medical health care (insurance) organization is required
• Three (3) years of experience managing one or more phases of a small- to medium-sized project involving a minimum of five (5) cross-functional team members in a matrixed health care organization or closely related industry
• Needs experience in Epic Tapestry or Health Rules Payor and/or Guiding Care systems
• Needs experience in Medicare Advantage, Medicaid, and ACA/Healthcare Exchange Products
• PMP, PgMP, Scrum Master, Six Sigma Belt certification preferred

Project Manager with fulfillment centers

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