Program Manager III - Recovery Operations/Payment Integrity
New
C
CenteneHealthcare payment integrity
Applicants can work anywhere in the continental United StatesFull-TimeManager
Salary87,700 - 157,800 USD per year
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Job Details
- Experience
- 5+ years project implementation, product or program management experience.
- Required Skills
- Project Management
Requirements
- Bachelor’s degree in Business Administration, Healthcare Administration, a related field, or equivalent experience.
- Master’s degree preferred.
- 5+ years of project implementation, product, or program management experience.
- Managed care or prescription benefit management experience preferred.
- Experience driving initiatives within healthcare recovery operations, payment integrity, claims operations, revenue cycle, or related healthcare business functions preferred.
- Ability to manage projects through requirements gathering, project planning, scheduling, resource management, budgeting, execution, deployment, and closure.
- Knowledge of corporate and industry-standard project management tools and techniques.
- Ability to maintain project documentation, including action items, issue lists, and risk mitigation plans.
- Ability to provide functional and technical knowledge regarding program requirements and operations.
Responsibilities
- Lead recoupment claim inventory management and monitor BOT automation.
- Ensure Payment Integrity Amisys, Facets, Xcelys, and ABS recovery processes operate as expected, resolving issues timely.
- Review savings BOT automation issues and identify potential concerns.
- Identify opportunities to increase efficiency, improve service levels, and ensure regulatory compliance through enhanced operations.
- Develop strategies for improvement opportunities and align organizational priorities and resources.
- Manage projects through the full project life cycle, from requirements gathering and planning through execution, deployment, and closure.
- Use corporate and industry-standard project management tools and techniques.
- Maintain project documentation, including action items, issue lists, and risk mitigation plans.
- Communicate project status to stakeholders through updates, executive summaries, and presentations.
- Lead cross-functional meetings and collaborate with recoupment program SMEs, IT, and Claims teams to resolve issues.
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