Payment Integrity Specialist – Regulatory

Jobtailor; Deutschland; Remote; EUR 90.000 - 120.000; Vollzeit

Zusammenfassung

Jobtailor is seeking an experienced Project Leader to drive strategic initiatives in the health care and insurance space. You will develop business cases, align initiatives with corporate plans, and transition approved cases into actionable programs across cross-functional teams.

The role requires PMP certification, 6+ years of project management, and strong data analysis, planning, and communication skills. A master’s degree is preferred.

Qualifikationen

• Bachelor's degree or equivalent required.
• 6+ years of project management experience required.
• PMP certification mandatory.
• Master's degree preferred.
• Experience in health care or insurance preferred.
• Process quality certification preferred.
• Compliance with all policies and standards.

Aufgaben

• Lead business case development for initiatives.
• Support strategic planning and initiative prioritization.
• Ensure alignment with business plans and objectives.
• Transition approved cases into initiatives with clear ownership.
• Drive large-scale cross-functional initiatives for performance and compliance.
• Provide policy guidance for assigned initiatives.
• Organize teams, facilitate meetings, document recommendations, oversee implementation.
• Analyze data, workflows, policies, staffing, and skills.
• Utilize Excel, PowerPoint, Visio, and MS Project for planning.
• Lead staff supporting operating-plan initiatives and their development.
• Assist other leaders with facilitation, analysis, and process mapping.
• Prepare and deliver communications across organizational levels.
• Support improvements to business performance.

Kenntnisse

Leadership

Facilitation

Communication

Consensus Building

Team Organization

Ausbildung

Bachelor's Degree in related field

Master's Degree in related field preferred

PMP Certification

Process Quality Certification

Tools

Microsoft Project

Excel

PowerPoint

Visio

Jobbeschreibung

• Lead business case development for proposed initiatives


• Support strategic and business planning, including initiative prioritization


• Ensure initiatives align with strategic business plans and business objectives


• Transition approved business cases into initiatives with clear documentation and responsibilities


• Lead large-scale, cross-functional initiatives focused on performance improvement, financial gains, customer satisfaction, and improved compliance


• Provide strategic and policy guidance for assigned initiatives


• Organize work teams, drive consensus, facilitate meetings, document recommendations, and oversee implementation


• Analyze data, workflows, policies, procedures, staffing organization, and skills


• Use project management software including Excel, PowerPoint, Visio, and Microsoft Project


• Lead staff responsible for operating-plan initiatives and support their development and completion


• Assist other project leaders with facilitation, analysis, process mapping, brainstorming, and project management issues


• Write and deliver communications across all organizational levels


• Provide related support to improve business performance


• Perform other duties as assigned

Requirements

• Bachelor's Degree in a related field or equivalent experience required


• 6+ years managing projects required


• Certified Project Management Professional (PMP)-PMI required


• Master's Degree in a related field preferred


• Experience in health care and/or insurance preferred


• Process quality certification preferred


• Compliance with all policies and standards


• Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Core Competencies

Demonstrates expertise in leading large-scale, cross-functional initiatives focused on performance improvement and compliance, while effectively managing project teams and aligning initiatives with strategic business objectives. Proficient in project management methodologies and tools to drive successful outcomes.

Highest-signal resume keywords

• Project Management Professional (PMP)


• Business Case Development


• Data Analysis


• Process Mapping


• Health Care Experience

ATS Optimization Keywords

Hard Skills

• Project Management


• Initiative Prioritization


• Performance Improvement


• Financial Analysis


• Compliance Management

Soft Skills

• Leadership


• Facilitation


• Communication


• Consensus Building


• Team Organization

Certifications & Qualifications

• Certified Project Management Professional (PMP)


• Process Quality Certification

Industry Keywords

• Health Care


• Insurance


• Strategic Planning


• Policy Guidance


• Business Performance

Tools & Technologies

• Microsoft Project


• Excel


• PowerPoint


• Visio