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TPAHealth Plan Project Manager

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Title: TPA/Health Plan Project Manager
Location: Remote (Anywhere in the USA)
Duration: 612 Months
Implementation Partner: Sierra Solutions Group
End Client: To be disclosed
JD:
Position Description:
  • We are seeking a highly motivated and experienced Health Plan Project Manager to lead our integration efforts.
  • The ideal candidate will have strong Project Manager experience that has recent TPA (Third Party Administrator) OR Health Plan experience.
  • Candidates must be Six Sigma Certified.
  • This PM will be required to bring a combination of experience within the integration of operations both internal and ThirdParty Vendor Partners as well as integration of newly acquired lines of business.
  • 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 crossfunctional teams.
  • 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 postintegration evaluations to identify areas for improvement and ensure continuous optimization.
    Required Skills:
    • Bachelors degree in healthcare administration Business Administration Project Management or a related field. Masters degree preferred.
    • Six Sigma Certification
    • 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.

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