Payment Integrity Project Specialist

100% Hybrid (Onsite Cadence: Tuesday, Wednesday, Thursday.) Out of state not required to come on site.

Expenses allowed: to be decided

 Equipment to be Provided

Must Have

• Claims/Healthcare
   
• Influencing role
   
• Project management of large scale complex implementations.
   
• SLA agreements.

Nice To Have

Job Summary

Ensuring adherence to the Health Project Management methodology and quality standards, oversees various high-priority projects of mid to large size requiring considerable resources and high levels of functional integration. Responsible for assembling technical and operational project team members, coordinating activities, assigning individual responsibilities, identifying appropriate resources needed, and developing schedules to ensure timely completion of a project. Takes projects from original concept through final implementation. Able to grasp concepts required to understand the overall project scope, and to communicate effectively with project team members, end users and external resources. Manages the integration of vendor tasks and deliverables. Competent to work at the highest levels of all phases of project leadership. Regularly provides guidance, direction and training to less experienced Project Managers.

Essential Functions

• Oversees highly complex projects/programs with appropriate departmental and leadership relationship management, and project management. Responsible for the management of multiple projects: Develops project plans, budgets and schedules. Coordinates project work, and completes projects on time and within budget. Works with/leads the constituent Project Managers/workgroup leads responsible for the execution of their areas of a project to monitor cost, schedule and technical performance of component project and operation, while working to ensure the ultimate success of the program. Acts as a mentor and/or consultant to others.
• Assesses resource requirements for projects and negotiates for resources with management to meet project plan deliverables. Organizes and works with appropriate leadership, departments and leaders to plan and schedule the coordination of people and tasks as needed to accomplish project objectives.
• Appropriately manages vendors from initial contracting through project completion. Serves as the leader for assignment of work activities, escalation of project related issues, service delivery, and customer satisfaction. Able to coordinate activities of numerous, diverse areas simultaneously.
• Serves as a liaison for projects between various departments within the client. Communicates, collaborates, networks with and acts as a consultant to stakeholders and business partners in order to ensure continuity and coordination of services and appropriate utilization of resources.
• Analyzes and documents processes, procedures and outcomes to seek continuous improvement.
• Ensures adherence to the  Project Management methodology and quality standards. Acts as a change agent to advance the knowledge and use of project management and the project management methodology and toolset.

Qualifications

• Required Bachelor''''s Degree or equivalent
• Preferred Master''''s Degree or equivalent
• 3 years of relevant experience in the field Required
• 5 years of relevant experience in the field Preferred
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