Salary
💰 $123,288 - $184,932 per year
About the role
- Identify and implement projects, programs and plans that support business unit and enterprise goals
- Specialize in planning, project portfolio, or culture/change or support Payment Integrity business unit
- Identify potential issues, project change, and scope data with focus on payment accuracy, claims validation, and audit readiness
- Lead efforts to identify best practices and design processes and systems to support business needs
- Design methods for integrating functions and processes where claims adjudication, provider billing, and fraud/waste/abuse prevention intersect
- Conduct cost/benefit analyses to evaluate payment integrity initiatives, technology investments, and process improvements
- Build support for business change emphasizing compliance, accuracy, and member/provider trust
- Provide process, project, and change management coaching/consulting support to local and enterprise wide initiatives
- Lead project prioritization and scheduling activities for the business unit
- Provide expertise in culture/change management, process planning, portfolio management, and support execution of the operating plan with focus on payment integrity objectives
Requirements
- Requires a BA/BS in a related field
- Minimum of 10 years managing mid to large-scale change/project initiatives
- Or any combination of education and experience which would provide an equivalent background
- Payment Integrity knowledge and experience strongly preferred
- Knowledge of planning models and methodology
- Project management and change management experience (strategic and execution) strongly preferred
- Process Improvement experience strongly preferred
- Masters degree preferred
- Six Sigma Green/Black Belt preferred
- Microsoft PowerPoint and Excel skills preferred
- Associates required to be in-office 3 days per week; candidates not within a reasonable commuting distance from the posting location(s) will not be considered unless accommodation is granted