Medicaid Implementation Senior Project Manager

Responsibilities

The Senior Project Manager oversees the full project life cycle for State Medicaid implementations, managing cross-functional teams to meet strategic objectives within budget and scope. They are responsible for project planning, risk mitigation, stakeholder communication, and ensuring adherence to quality standards throughout the implementation process.

Requirements

Candidates must possess a Bachelor's degree or at least 5 years of experience in a managed care healthcare system, along with 5+ years of project management experience. Proficiency in Medicaid/Medicare operations, change management, and Microsoft Office is required.

Skills

• Project management
• Medicaid
• Medicare
• Change management
• Claims lifecycle
• Strategic planning
• Risk management
• Stakeholder management
• Cross-functional leadership
• Process mapping
• Workflow design
• Microsoft Office
• Smartsheet
• Jira
• Business analysis
• Quality control

Benefits

• Medical
• Dental
• Vision
• 401(k) retirement savings plan
• Paid time off
• Company holidays
• Personal holidays
• Paid parental leave
• Caregiver leave
• Short-term disability
• Long-term disability
• Life insurance
• Bonus incentive plan

About this role

Become a part of our caring community
Humana Healthy Horizons is seeking a Medicaid Implementation Senior Project Manager to manage all aspects of a project, from start to finish, so that it is completed on time and within budget. The Medicaid Implementation Senior Project Manager work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. This role mainly focuses on the "Business" side of State Medicaid Implementations with very limited scope in the IT implementation activities. Individuals with business process change management and project management are best suited for this role.
The Medicaid Implementation Senior Project Manager roles and responsibilities:
Plan, organize, monitor, and oversee complex projects utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.
Assists in training and perform duties as the dedicated Project Manager.
Manages the full project life cycle, including review of various sources to assess requirements, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment, and closure.
Maintains detailed project documentation including meeting minutes, action items, issues lists, project plans, and risk management plans.
Provides leadership and effectively communicate project status to all stakeholders and external agencies.
Negotiates with project stakeholders to identify resources, resolve issues, and mitigate risks.
Coordinates cross-functional meetings with various functional areas to meet overall stakeholder expectations and company’s objectives.
Provides functional and technical knowledge across multiple business and technical areas.
Monitors the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.
Provides on-site leadership for project team by building and motivating team members to meet project goals, adhering to their responsibilities and project milestones.
Works creatively and analytically in a problem-solving environment demonstrating teamwork, innovation, and excellence.
Provides status reporting regarding project milestones, deliverable, dependencies, risks and issues, communicating across leadership.
Understands interdependencies between technology, operations, and business needs.
Acts as an internal quality control check for the project and participates in quality issue resolution.
Defines the Statement of Work and Specifications for the requested Medicaid Contract/RFP.
Sets and continually manages project and program expectations while delegating and managing deliverable with team members and stakeholders.
Delivers appropriate and effective executive level communication.
Ensures that projects and programs are proceeding according to scope, schedule, budget, and quality standards.
Manages project/program issues and risks to mitigate impact to baseline.

Use your skills to make an impact
Required Qualifications
Bachelor's Degree or 5+ years working in a managed care healthcare system or health plan
5+ years of Project Management experience working with large size initiatives.
2+ years of experience in Change Management.
Possess a solid understanding of operations, technology, communications, and processes.
Experience working in Medicaid and/or Medicare.
Experience in Claims Lifecycle Initiatives.
Proficiency in Microsoft Office programs.

Preferred Qualifications
2+ years of leadership experience in a matrixed environment
Knowledge of Systems Development Life Cycle, Waterfall, and Agile Development Methodologies.
Experience in business operations or consulting services in a health plan.
Experience with Smartsheet (PM tool) and/or Jira
Experience in Process mapping and workflow design
Experience Identifying root causes and control gaps
Prosci, Six Sigma, and/or Project Management Institute certifications.

Additional Information
Schedule/Time Zone: Remote: Monday through Friday - Typically, 8-5 pm (Eastern Time Zone)
Work Location: US Nationwide
Travel Requirements: Up to 10% to Humana office location

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$86,300 - $118,700 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement ...

About Humana

Insurance · 10,001+ employees · headquartered in Louisville, Kentucky