Position: Program Management Lead Analyst
Location: Fully remote job
Duration: 06+ Months Contract (Possible extension)
Schedule - 8-5 CT
Duties:
Highlight of the position per manager: The focus won't be tracking CMS deliverables; it will be tracking other operational projects that impact business processes.
Position Product:
- Responsible for all CMS deliverables for Utilization Management, Care Management, Behavioral Health, and Special Needs Plans
- Coordinates all internal/external audit activities
- Serves as liaison with Compliance and Privacy
- Identifies and implements process improvements
- Establishes and manages operational and business readiness processes to ensure the successful implementation of funded projects, baseline maintenance/fix, infrastructure upgrades, as well as operational changes impacted by process changes
- Participate in business requirements to ensure applicability to operational areas when changes are implemented
- Responsible for tracking key project and release milestones, escalating risks, confirming mitigation plans and adjusting plans and/or resources to meet the needs of customers and CMS timeframes.
- Must have extensive expertise in the use of project management methodologies and tools.
- Applies human resources policies/practices and change management techniques.
- Major responsibilities and desired results:
- Responsible for all CMS deliverables. Coordinates responses ensuring accurate, complete submission.
- Works with Compliance and business to identify impacts to processes as a result of changes in regulations ( HMPS memos).
- Tracks Corrective Action Plans ( CAPs ); works with business owners to drive timely closure.
- Creates and maintains all policies and procedures for the functional area.
- Responsible for continuous process improvement activities. Documents current and future state. Leads change management activities associated with updates to processes.
- Collaborates with leadership to prioritize projects.
- Establishes and executes end to end universe data validation. Includes review and correction of data integrity issues in source systems.
- Facilitate operational readiness and implementation to ensure teams are prepared for changes impacting business functions, roles, people and processes.
- Drive and strengthen partnerships with Business Development Team, Compliance and IT, to ensure successful identification of business impact, communication, procedures, training, delay, and business checkout needs.
- Build and maintain appropriate business readiness communication processes and engagement models to accommodate frequent internal and matrix partner organization changes.
- Maintain efficient and informative lines of communication between business and matrix partner leadership.
- Enhance established processes and engagement models as needed to ensure business readiness.
- Identify and execute process improvement opportunities and eliminate barriers to improve quality, implementation readiness, and reduce rework.
- Bring together Business and IT leadership to resolve escalated conflicts.
- Required to work over occasional weekends and odd hours.
Education:
High School Diploma Required
Bachelor's Degree or relevant work experience preferred
Not Required but would prefer PMP, Six Sigma, or some other relevant certification.
Languages:
English( Speak, Read, Write )
Certifications & Licenses:
PMP
Skills:
- Top 3 skills:
- Independent, quick learner. Excellent communication skills. Strong problem-solving skills.
- Requirements
- Operations experience preferred in Utilization Management, Care Management, Behavioral Health, and Special Needs Plans; Knowledge of FDR/IPA's a plus
- Medicare Advantage experience preferred with focus on regulatory compliance or auditing
- Health Insurance experience required; Knowledge of NCQA requirements a plus
- Strong analytical and problem-solving skills
- Excellent communication skills and ability to interact with all levels and diverse partners
- Strong influencing and negotiation skills. Ability to influence without authority.
- Independent, quick learner with ability to impart knowledge to others effectively
- Proven leadership skills
- Ability to build solid working relationships with staff, matrix partners, customers and providers
- Demonstrated process improvement experience
- Strong knowledge of Microsoft Office products including Excel, PowerPoint, Word, and Project. Mastery skill in Excel required.
Company:CONFIDENTIALLocation:Atlanta - Georgia - United StatesJob Types:ContractPost Date:November 2, 2021Valid Through:December 1, 2021