Sr. Project Manager Healthcare Contract
Dev Technology Group60,000 - 90,000 USD/year
- Full Time
- Mid-level (3 to 4 years), Senior (5 to 8 years)
Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
Health Insurance, Managed Care, Healthcare ServicesIndustries
Requirements
Candidates should possess a Bachelor’s degree and a minimum of 5 years of experience in healthcare, health insurance, or case management, along with at least 2 years of experience in a management role leading people. Experience in process improvement methodologies is required, and preferred qualifications include managed care experience and certifications such as Six Sigma Lean or project management.
Responsibilities
The Process Improvement Manager will oversee the development of policies and processes for the Long Term Care Services and Supports (LTSS) market, ensuring compliance with established guidelines and contracts. They will manage a team of process professionals, leverage strategic thinking in project management, and develop strategies to address contract changes and mitigate non-compliance. The role involves researching best business practices, monitoring system efficiency, assisting in achieving HEDIS compliance, supporting NCQA accreditation, and serving as a point of escalation for system issues. Additionally, the manager will manage the completion of various state reports and collaborate with corporate partners to enhance the system.
Skills
Business Process Improvement
Healthcare Industry Knowledge
Contract Management
Policy Development
Project Management
Regulatory Compliance
HEDIS
NCQA Accreditation
Team Leadership
Strategic Thinking
Humana
Health insurance provider for seniors and military
About Humana
Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.
Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees