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Description
Job Description
Job Title:
Project Lead - Medical Cost Management
Job ID:
11144
Location: Virginia Beach, VA
Full/Part Time:
Full-Time
Regular/Temporary:
Regular
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Responsibilities
JOB SUMMARY:
An experienced project leader, facilitator, innovator, and champion who manages multiple projects focused on Medical Cost Management (MCM). Accountable for having a broad understanding of key MCM priorities and deliverables with demonstrated ability to work independently with internal clients. The individual must have significant experience identifying opportunities for improvement, resolving problems, working with stakeholders both inside and outside of a department, and implementing plans for improvement within established timeframes.
The Senior Project Leader will analyze existing quantitative and qualitative information, current workflows and processes, form and facilitate work teams to achieve objectives, write clear and concise documents including project proposals and reports.
The Senior Project Leader develops clear and thoughtful presentations for groups of all sizes and levels, including senior management. The position must be an experienced and confident speaker who understands the details of the projects and underlying business goals. Works with all levels of staff and management to facilitate development and change. Facilitates the participation of individuals and departments in projects and activities. Performs other duties as assigned.
PRIMARY RESPONSIBILITIES:
1. Understand the organizational goals of key projects and work with the project sponsor to create a roadmap to project completion.
2. Facilitate/chair team meetings required for project implementation.
3. Identify resources needed and assign individual responsibilities.
4. Track assigned action items and maintain accountability of team members.
5. Review deliverables prepared by team.
6. Prepare for team meetings including agendas, minutes, and action items.
7. Manage project budget where appropriate.
8. Manages the day-to-day project management activities for assigned MCM projects. This includes crisis escalation and resolution, and interaction with business owners.
9. Develops Project Plans and compares baseline versus actual.
10. Manages the critical path and escalates any negative or positive deviation to HCMS management.
11. Develops Risk Management Plans, Project Status Reports, and Communication Plans.
12. Performs Lessons Learned and captures process improvement opportunities related to project delivery.
13. Mentors project team in project management and applicable standards.
14. Coordinates and directs all project-related activities to meet project deadlines.
15. Ensures that service levels meet agreed-upon standards with business owners.
16. Provides in-depth knowledge of company-wide business processes and advance knowledge of industry standard business processes.
17. Responsible for developing contingency plans to ensure department business plan objectives are met.
18. Adheres to departmental and corporate Policies and Procedures as outlined by Management.
EDUCATION AND EXPERIENCE:
Education Required:
Bachelor's degree in business administration or health care-related field. Equivalent experience is acceptable in lieu of a degree
Education Preferred:
Medical coding and research experience preferred
Years and Type of Experience Required: Required:
Three to five years of experience managing complex project implementation.
Possesses problem solving and project management skills. Must be able to take charge, manage numerous projects and successfully coordinate projects with internal areas and external vendors.
Demonstrates analytical skills necessary to size opportunities and adjust targets based on regulatory requirements.
Project team member oversight management and/or supervisory experience required.
Demonstrated ability to supervise, motivate, develop and direct teams of clinical and non-clinical associates.
Demonstrated record of bringing together diverse functions and building effective teams.
Excellent consultative, communication, leadership, negotiation, and motivational skills.
Demonstrated ability to deliver quality customer service.
Ability and willingness to step in and provide hands-on support when needed.
Experience identifying and pursuing business opportunities for innovation within the organization
Must be positive and upbeat, bringing both professional focus and ability to motivate and direct teams to world-class service and quality.
Years and Type of Experience Preferred:
Medical claims, coding, and/or research experience
Broad operational managed care background.
Medicaid or Medicare experience
Specific Technical Skills Required:
MS Office applications
MS Project and\or MS Project Server background.
Specific Technical Skills Preferred:
Medical Claims
Medical Coding
Certifications or Licensure Preferred: PMP Certification
Other Required:
Strong analytical, problem solving and quantitative analysis skills. Able to turn problems into opportunities for change.
Ability to work in a fast paced environment managing multiple priorities simultaneously.
Able to develop and manage multiple projects with minimal direction and supervision.
Able to deliver a planned presentation to an audience.
Able to create a presentation on a specific topic.
Able to motivate others, provide innovative ideas and solutions, and promote the department vision for improvement and integrate that with others in the organization.
Able to continually assess needs and implement measures that will ensure customer expectations are met or exceeded.
Excellent interpersonal skills, including the ability to work with all levels of personnel including, but not limited to peers and Senior Management within the organization.
Strong negotiation and facilitation skills.
Appreciation of cultural diversity and sensitivity towards target population.
Preferred:
Knowledge of managed care including, but not limited to claims adjudication and payment, medical management, provider fee-for-service reimbursement, capitation, billing, enrollment, and benefits.
SCOPE INFORMATION
Item Measure
# Direct Reports 0
# Indirect Reports None
Budgetary $ Responsibility TBD
KPI Department Standards Yes - as determined
PHYSICAL REQUIREMENTS
Must be able to operate a PC for extended periods of time.
Must be able to operate and effectively utilize office telephone equipment.
Equal Employment Opportunity
In accordance with state and federal laws, employment offers are tendered solely on the basis of qualifications without regard to race, religion, color, national origin, age, sex, marital status, sexual orientation, handicap (including disabled veterans) or Vietnam Era veteran status.
AMERIGROUP administers pre-employment drug testing as a condition of employment and a satisfactory criminal history background report.
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Details:
Job Id:
754700A0
Posted / Updated:
4/9/2010 3:32:29 AM
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