Senior Project Manager

We have relaxed the requirement of candidates having TPA (Third Party Administrator) experience. Although it is still HIGHLY PREFERRED, we will now consider candidates who have Health Plan experience for this role.

The rest remains the same and required. To simplify what we are looking for now, is the following :

True Project Manager experience and RECENT within a Health Plan / Payor (i.e. any Blue Cross plan, United / UHG, Optum, Anthem / Amerigroup / Elevance, etc.

etc.) . If you have questions about this, please ask.

• PMP certification is also ideal.
• Six Sigma certified
• Integration and migration experience. Specifically, experience with :

integration of operations both internal and Third-Party Vendor Partners . integration of newly acquired lines of business .

Full details below.

Title : Health Plan Project Manager

Location : Remote (client is located in Seattle, WA)

Start Date : ASAP

Duration : 6-12 months to start

Position Description :

• We are seeking a highly motivated and experienced Health Plan Project Manager to lead our integration efforts.
• True Project Manager experience and RECENT within a Health Plan / Payor (i.e. any Blue Cross plan, United / UHG, Optum, Anthem / Amerigroup / Elevance, etc.

etc.) . If you have questions about this, please ask.

• PMP certification is also ideal.
• Six Sigma certified
• Integration and migration experience. Specifically, experience with :
• integration of operations both internal and Third-Party Vendor Partners .
• integration of newly acquired lines of business .
• The successful candidate will be responsible for managing the integration of various health plan components, including IT systems, provider networks, and member services.
• This role requires a strong understanding of health plan operations, excellent project management skills, and the ability to work collaboratively with cross-functional teams.

Responsibilities :

• Lead and manage integration projects for health plan systems, ensuring alignment with organizational goals and objectives.
• Develop and maintain detailed project plans, including timelines, milestones, and deliverables.
• Coordinate with internal teams and external partners to ensure successful integration of systems and processes.
• Identify and mitigate project risks, resolving issues promptly to keep projects on track.
• Ensure compliance with regulatory requirements and industry standards throughout the integration process.
• Provide regular updates to senior management on project status, highlighting achievements and addressing any concerns.
• Facilitate effective communication and collaboration among stakeholders, including IT, operations, provider networks, and member services.
• Conduct post-integration evaluations to identify areas for improvement and ensure continuous optimization.

Required Skills :

• Bachelor’s degree in healthcare administration, Business Administration, Project Management, or a related field. Master's degree preferred.
• Six Sigma Certification
• PMP or similar project management certification.
• Minimum of 8-10 years of experience in project management within the healthcare or health plan industry ( candidates who have recent TPA experience will receive first consideration over others).
• Proven track record of leading successful integration projects, preferably in a health plan environment.
• Strong knowledge of health plan operations, including claims processing, provider networks, and member services.
• Excellent organizational and multitasking skills, with the ability to manage multiple projects simultaneously.
• Exceptional communication and interpersonal skills, with the ability to work effectively with diverse teams and stakeholders.
• Proficiency in project management software and tools.
• Understanding of regulatory requirements and compliance standards in the healthcare industry.
4 days ago