Title: TPA/Health Plan Project Manager
Location: Remote (Anywhere in the USA)
Duration: 6-12 Months
Implementation Partner: Sierra Solutions Group
End Client: To be disclosed
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Position Description:
- We are seeking a highly motivated and experienced Health Plan Project Manager to lead our integration efforts.
- The ideal candidate will have strong Project Manager experience that has recent TPA (Third Party Administrator) OR Health Plan experience.
- Candidates must be Six Sigma Certified.
- This PM will be required to bring a combination of experience within the integration of operations both internal and Third-Party Vendor Partners as well as 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 is highly desirable.
- Minimum of 5 years of experience in project management within the healthcare or health plan industry.
- 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.
