Health Plan Project Manager

Job Summary

We are seeking a Health Plan Project Manager for our Benefits Administration client. 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. We are looking for candidates who are Six Sigma Certified Health Plan or TPA experienced who ideally bring a combination of experience within integration of operations both internal and Third Party Vendor Partners as well as integration of newly acquired lines of business.

Primary 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.

Education and Experience

• Bachelor's degree in Healthcare Administration, Business Administration, Project Management, or a related field. Master's degree preferred.
• 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.