Program Manager - Medical Management

Job Summary

A company is looking for a Program Manager - Medical Management - Remote.

Key Responsibilities

• Develop, evaluate, coordinate, implement, and monitor all Payment Integrity (PI) initiatives across the health plan
• Oversee and drive accountability through the Plan PI Committee, including tracking initiatives and addressing roadblocks
• Create manual and automated workflow pathways, and vet plan policies, regulations, contracts, and benefits

Required Qualifications

• Bachelor's Degree
• 3 years of healthcare experience in project coordination, including operations analysis and quality improvement
• 3 years of experience with performance improvement and organizational change tools
• 3 years of change management experience
• Experience in Six Sigma and/or Lean methodology