Population Health Project Manager

at  Moda Health

REQUIRED SKILLS, EXPERIENCE & EDUCATION:

• Bachelor degree in Business Administration, Health Services Administration, or related field, required. Masters preferred.
• 5+ years of business experience in project management and/or project coordination roles or equivalent.
• Strong verbal, written, and interpersonal communication skills.
• Knowledge of health insurance business as it relates to provider and vendor contracts, marketing, processing of claims, handling of billings, customer service, and other related information.
• Ability to work well under pressure, work with frequent interruptions, and shifting priorities.
• Ability to maintain confidentiality and project a professional business image.

Primary Functions:

• Identify, size, and prioritize key initiatives. Define, scope, plan, communicate and execute assigned projects.
• Manage projects associated with implementing/operationalizing new programs, policies and/or procedures. Includes end-to-end project oversight, calculating, reconciling, and auditing programs and their impact. Report findings and status to all levels of the organization, including executives.
• Identify opportunities for improved efficiency and/or effectiveness associated with Healthcare Services business objectives. Gather business requirements and assist in Healthcare Services department business process re-engineering.
• Conduct process analyses to identify and develop improvements. Make recommendations on next steps and manage deliverables.
• Monitor project compliance with Moda, CMS, QHP, State Specific, and NCQA requirements. Ensure development of supporting P&P and workflow. Consistently monitor for changes to requirements and work with internal stakeholders to implement new requirements.
• Develop and document policies, procedures, processes and workflows for Population Health and Quality department functions.
• Work with other department stakeholders to assess upstream and downstream impact of process improvement efforts. Document and communicate changes to standards and workflow processes.
• Participate in daily and project driven activities relating to the support of Healthcare Services Division
• Perform other duties as assigned.

Please refer the Job description for details