Medicare programs and regulations Project Manager

Project Manager
Location: Eagan, MN

Experience: 7+ yrs.

Skills: Waterfall, Agile, HEDIS, NCQA Health Plan Accreditation, project gateway process, project change request process, rapid approval process, data integration platforms
Duration: 8+ yrs

The Impact You Will Have

• Responsible for the success of new projects and programs through intentional leadership of assignments and mentoring of project managers in the areas of professional conduct, project management methodology, the use of project management tools, interpersonal skills and navigation of the project gateway process, project change request process and the rapid approval process.
• Participates in the coaching, mentoring, and training of others.

Your Responsibilities

• Understand the strategy and future direction of the organization, as well as challenges and opportunities that are inherent to that strategy and direction.
• Ensure that the objectives and priorities of the project or program are aligned with the company's strategic direction.
• Directs the activities of individuals representing multiple business areas to achieve results in a matrix-ed organizational structure, managing across the organization to achieve project objectives.

Required Skills and Experience

• Bachelor s degree and a 7 years experience leading large, complex initiatives with increasing responsibilities in project management or continuous improvement or 11 years of equivalent work experience in lieu of a degree.
• Demonstrated track record of achievement with ability to identify and exceed customer expectations.
• Demonstrated ability to collaborate effectively with diverse business stakeholders, including those with strong and assertive personalities; must be comfortable navigating challenging interpersonal dynamics, managing expectations, and maintaining focus on delivery while fostering respectful and productive working relationships.
• Demonstrated proficiency in managing projects that incorporate both traditional Waterfall and Agile frameworks, ensuring seamless integration and effective delivery.
• Excellent continuous quality improvement and/or project management skills.
• Must have a high level of intellectual curiosity and openness to change.
• Strong conflict resolution, facilitation, and negotiation skills, capable of adapting the approach as needed.
• Excellent verbal, written and presentation communication skills.
• Demonstrated creative problem-solving skills, able to anticipate, identify and eliminate problems.
• Proven ability to collect and analyze feedback and data and transform findings into project-level strategies.
• Demonstrated ability to work independently with little to no direction and make decisions as needed.

Preferred Skills and Experience

• Master s degree in business or related field.
• Knowledge of team leadership and team member mentoring for success.
• Experience in the Healthcare industry.

Project Overview:

• Member data from any client managed on an external platform must be included in the annual HEDIS data, as required by NCQA Health Plan Accreditation. This accreditation mandates that the reported population aligns with HEDIS. Currently, access to the HEDIS platform is provided through a third-party contract that restricts the integration of data from other platforms. While exceptions have been granted in the past due to the small size of the affected population, planned growth through increased product sales will make future exceptions unlikely, putting accreditation at risk.
• The proposed solution is to end our agreement with our current vendor, and work directly with a vendor that can support all populations, increasing efficiency and reducing turnaround time.
• The Project Manager/Delivery Lead will work with the internal teams, and current vendor, as we transition work off of their platform.