Sr Project Manager Care Management - APPLY BELOW

Projé is continually growing therefore, we are currently seeking a qualified, highly motivated, experienced individual for the position of Sr. Project Manager – Care Management. Our clients need a strong Care Management Project Manager to lead various types of projects. Current responsibilities would include working with the client to define Project Assessments, Planning, Testing, Training and Implementation, Issue and Risk mitigation for Clinical/Business/Technical deliverables using industry standard best practices. Review, organize, roadmap, and strategize with Managers, Directors, Sponsors and Executive Management to implement documented changes.

 

Strong PM skill set necessary, ability to plan and manage workflows with Clinical, Business, and Technical Client Leadership is a must. Project Status Reporting, Requirement gathering, experience managing multiple projects preferred. Must be able to lead a team of PM’s, BA’s, clinicians, and vendors.

 

In-depth experience and knowledge of CM (case management), DM (disease management), and UM (utilization management), clinical state and federal regulations, clinical workflows, and an overall deep understanding in care management and best practices.

 

Working closely with all departments, individual will assist with strategy, scoping, levels of effort involved, and will take the lead on the coordination and creation of the solutions for success. Individual is responsible for advising and guiding clients to an effective solution. Once a solution is defined, person must also be able to confidently convey their ideas to the client in a clear fashion with visual references & diagrams where appropriate. Create and deliver solutions presentation to all levels of Leadership.

 

Strong business acumen and ability to reach milestones within a structured system, while remaining flexible enough to meet deadlines and goals through a dynamic changing business climate is required. Responsibilities would include working with Clinical, Business, and Technical Managers to implement methodologies and standards to be used on projects. Exceptional Project Management skill set necessary, ability to plan and manage workflows with Clinical, Business, and Technical Client Leadership. Project Status Reporting, Requirement gathering, experience managing ITS and FEP Projects strongly preferred.

 

Responsibilities

  • Leads Strategy, Planning and, Issue/Risk Mitigation and Requirements sessions.

  • Oversee and monitor progress, adopt and implement tools used by the client PMO.

  • Provides client with effective solutions.

  • Creates visual references & diagrams, where appropriate to convey ideas and solutions to the client in a clear fashion.

  • Identify and review with the client required testing methodologies and application of testing methodologies to ensure quality.

  • Identifies and communicates risks and issues that may require changes to plans or scope.

  • Organizes and synthesize large amounts of information and provide to stakeholders in a meaningful fashion.

  • Ensures implemented process improvements are documented and control documentation for traceability and future reuse.

  • Facilitate management and executive level meetings.

  • Understands project/program needs among diverse colleagues in various departments (Claims, Medical Management, Enrollment & Billing, Sales & Marketing, IT, Business Process Improvement, etc.).

  • Identifies training needs and directs the client in the planning of training classes required to implement changes in business process and technical operations on peripheral systems.

  • Evaluates and report project dependencies and impacts on multiple client projects.

  • Creates evaluation of work effort and resource planning and the development of an overall project schedule.

  • Oversees all aspects of the project schedule throughout the SDLC life cycle, from initial kickoff through requirements analysis, design, and testing and implementation phases for the project.

  • Ensures project documents are complete, current, and stored appropriately.

  • Collaborates with all interested parties and participating project Stakeholders to ensure the planned approach achieves approval.

  • Works with the analytics team to create a roadmap of tools and KPIs for the solution’s measurement of success.

  • Assists with the assessment and vetting, of new technical/software partnerships.

  • Manages projects from inception to implementation, ranging from new product/line of business implementation, business continuity planning, configuration optimization, legislative changes, etc.

  • Assumes project management role with impartiality in mind without favoring one department versus another and with enterprise common goals in mind.

  • Facilitates or participates in process improvement brainstorming sessions.

  • Writes project documents including charters, business requirements, project plan, training, policy and procedures, etc. using project expertise.

  • Interfaces with ITS and FEP to ensure the business requirement documentation meets the contract specifications.

  • Coordinates the completion of business processes and policies and procedures documentation, as needed.

  • Performs other related duties and special projects as assigned.

 

Education and Experience

  • 10+ years practical experience in managing large projects.

  • PMP and/or Six Sigma Belt certification required, and knowledge of formal business process improvement.

  • Bachelor’s degree in healthcare administration or a related field or equivalent experience. Master of Health Administration or related field is preferred.

 

Key Qualifications

  • Meticulous attention to detail.

  • Superb English language communication skills, both verbal and written.

  • Strong ability to influence without authority.

  • Expert in the presentation of project idea, status, solution and results.

  • Proven skills in data analysis and presentation of data.

  • Strong analytical, problem solving, negotiation, and collaboration skills.

  • Ability to produce accurate and precise work, detect discrepancies and resolve discrepancies all while meeting deadlines.

  • Proven success in multiple project implementations.

  • Prior experience in health plan or management consulting roles is desirable.

  • Formal project management training and actual real-life experience in managing programs is a must.

  • Proven ability to manage and participate in several projects at the same time.

  • Produce high-level visuals & diagrams as needed.

  • Proficiency with MSOffice skills (Visio, Project, Outlook, Word, Excel, PowerPoint) SharePoint required.

  • Assist project leaders with the creation of hardware/software budget estimates, implementation timelines, and resource estimates for new projects or system enhancements.

  • Proven experience in two or more of the following: ICD-10, Medicaid, Medicare, BCBS, ITS, FEP, knowledge of healthcare governmental strategy and business model.

 

Desired Skills & Experience

  • General understanding of the health payer capabilities framework, including member services and operations, claims, provider services, health management, pharmacy, risk adjustment, and sales and marketing.

  • Health payer large systems implementation experience, specifically in the areas of case management, utilization management, and disease management for the commercial group/individual, Medicare, Medicaid, Behavioral Health, and Wellness lines of business.

  • Familiarity with an operational readiness approach, such as ADKAR, to establish enterprise-wide communications plans and change strategies for large-scale systems implementations.