JOB SUMMARY:

PENNEP is looking for a dynamic and experienced Project Manager with expertise in claims system management. This role involves leading projects related to claims system implementation, optimization, and integration. The ideal candidate will have a strong understanding of healthcare claims processes, system configuration, and project management best practices.

QUALIFICATIONS:

• 5+ years of experience managing projects within claims systems (Facets, HealthEdge, QNXT, or similar).
• Strong knowledge of claims processing workflows, including adjudication, appeals, and reimbursement.
• Proficiency in project management tools (e.g., MS Project, Jira) and methodologies (Agile, Waterfall).
• Excellent communication, leadership, and problem-solving skills.
• Familiarity with regulatory and compliance standards in healthcare (e.g., HIPAA, CMS).

EDUCATION:

Bachelor’s degree in Business, Information Technology, or a related field.

• Manage end-to-end project lifecycles for claims system implementations and enhancements, ensuring timely delivery and within scope.
• Collaborate with cross-functional teams, including IT, claims processing, and operations, to align project goals with business needs.
• Oversee claims system configuration, integration, and testing, ensuring adherence to compliance and regulatory standards (e.g., HIPAA, CMS).
• Develop project plans, timelines, and budgets, and monitor project progress against KPIs.
• Facilitate stakeholder meetings, providing clear updates on project status, risks, and mitigations.
• Ensure system accuracy, functionality, and performance through comprehensive testing and validation.
• Lead training sessions for internal teams on system updates and process improvements.
• Document project milestones, risks, and post-implementation reviews for continuous improvement.