Project Manager

Blue Cross and Blue Shield of Massachusetts, Inc.; Halton Hills; On-site; USD 81,000 - 100,000; Full time

Job summary

An established industry player is seeking a Project Manager for its Credentialing & Peer Review team. This dynamic role involves managing projects that enhance healthcare delivery, overseeing educational programming for internal MDs, and developing policy manuals to improve operational efficiency. The ideal candidate will possess strong analytical and organizational skills, thrive in a fast-paced environment, and collaborate with diverse stakeholders. Join a forward-thinking organization that values inclusivity and offers opportunities for professional growth in a supportive workplace.

Qualifications

• 3-5 years' experience in managed care or healthcare delivery.
• Knowledge of state and federal regulations and NCQA standards.

Responsibilities

• Manage projects and initiatives through all phases, ensuring timely completion.
• Oversee meetings and communicate effectively with team members.

Skills

Project Management

Interpersonal Communication

Analytical Skills

Organizational Skills

Problem-Solving

Education

Bachelor's degree in healthcare administration

Master's degree or equivalent

Tools

Microsoft Office

Project Management Software

Job description

Credentialing & Peer Review's Project Manager is responsible for staff support, administrative and project management, quality improvement, and overseeing continuing medical education in a dynamic business environment. This position leverages strategic project management skills, interpersonal communication, independent problem-solving, and organizational skills to develop and coordinate projects related to credentialing, peer review, continuing medical education, and other HMM operational priorities.

The role also manages policy manual development, Credentials & Peer Review Committee preparation and scheduling, and serves as Blue Cross' CME Coordinator. Additional responsibilities include supporting efforts to improve data capabilities, including file audits and departmental analysis and reporting using Credentialing and Peer Review systems.

This position is eligible for the Flex persona, with in-office expectations for local candidates 2 days per week, subject to change based on business needs.

Your Day to Day

As part of the Credentialing & Peer Review (CPR) Team, the Project Manager works closely with the CPR's Director, Senior Credentialing Manager, and teams across the organization. This cross-functional role involves:

1. Managing projects and initiatives through all phases, developing deliverables, and tracking action items to completion;
2. Planning and overseeing meetings, and effectively communicating with team members and subject matter experts;
3. Managing Blue Cross Grand & Schwartz Rounds for 1,200+ attendees annually, ensuring impactful programming and continuous education for internal MDs;
4. Developing and maintaining CPR's policy manual, workflows, job aids, and process improvements to enhance efficiency; and
5. Leading regulatory responsibilities, including documentation for NCQA surveys, delegation policy reviews, updating Provider Central, and preparing quarterly dashboards.

We are Looking for

• Experience in delivering successful projects and optimizing healthcare workflows;
• A fast, meticulous learner with strong analytical, organizational, and research skills;
• Ability to collaborate with diverse stakeholders to achieve results and meet deadlines;
• Proficiency with Microsoft Office (additional project management software skills are a plus);
• Strong organizational skills with the ability to work independently under pressure and manage multiple tasks effectively.

What You Bring

• Bachelor's degree in healthcare administration or related field (required);
• Master's degree or equivalent (preferred);
• Three to five years' experience in managed care or healthcare delivery (preferred);
• Knowledge of state and federal regulations and NCQA standards.

What You Will Gain

• Contributing to high-quality, cost-effective healthcare through credentialing and peer review standards;
• Being part of an inclusive, rewarding workplace that values expertise and career growth;
• Potential for advancement in healthcare environments.

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Minimum Education Requirements

High school degree or equivalent required unless otherwise noted.

Location

Boston, Hingham

Time Type

Full-time

Salary Range

$81,450.00 - $99,550.00

The posted salary range reflects our current best estimate. Actual pay may vary based on education, experience, and organizational needs. This role is also eligible for variable pay and a comprehensive benefits package.

Why Blue Cross Blue Shield of MA?

We encourage diverse applications and believe in creating an inclusive environment. We are committed to your development and offer resources to support your success. Learn more about our company culture and opportunities by visiting our website. Join our Talent Community to stay informed about roles and news.

We support wellness and work/life balance, emphasizing a healthy, productive workplace.