Self Funded Healthcare Claims Project Manager

Job Title: Senior Project Manager
Self-Funded Healthcare Claims

Scope of the project:

SPYGLASS (NEW VENDOR CLAIMS SYSTEM) IMPLEMENTATION READINESS, INCLUDING SYSTEM ACCESS/TRAINING COORDINATION AND UAT ACTIVITY SUPPORT FOR OPERATIONS.

SPYGLASS CQR IMPLEMENTATION, INCLUDING CLAIMS REVIEW RESULTS DOCUMENTATION, PROGRESS METRICS REPORTING, AND EXIT CRITERIA CHECKPOINT MEETING COORDINATION.

INTEL CONNECTED CARE (SELF FUNDED PPO) -- EXTRA BUCKS REQUIREMENTS DOCUMENTATION AND CLIENT APPROVAL FACILITATION.

INTEL CONNECTED CARE -- HFLC REQUIREMENTS DOCUMENTATION AND CLAIMS SYSTEM CONFIGURATION COORDINATION.

INTEL CONNECTED CARE -- FCHN WORKFLOW DOCUMENTATION, CLAIMS SYSTEM CONFIGURATION VALIDATION, AND EDI CONNECTION COORDINATION.

Project meeting attendance fill in, including calendar management, meeting notes documentation, and action item follow-ups.

REQUIREMENTS:

HEALTHCARE EXPERIENCE:

Experience with (1) Production management, (2) Project deliverable development, (3) Project summary presentation development
Claims program management, executive presentation development, large system project implementation
Clear and concise communication (verbal and written)

VISIO WORKFLOW SOFTWARE EXPERT

Powerpoint presentation software expert
Organized

EASY GOING

Energetic
Bachelor degree required
Min. 8 years related experience

WHAT I AM REALLY LOOKING FOR IS:
a resource who can translate raw info into business requirements and solution design documentation, secure supplier and customer approval, work with vendor to implement the requirements and design, and support them in a production environment.