Medicaid Implementation Senior Project Manager

Humana; Charleston (WV); Remote; USD 86,000 - 119,000; Full time

Benefits offered by this job

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Parental and caregiver leave

Disability and life insurance

Job summary

Humana Healthy Horizons is seeking a Medicaid Implementation Senior Project Manager to lead complex projects from initiation to closure, ensuring on-time delivery and budget adherence. The role emphasizes business-side leadership with limited IT scope, requiring strong project management and change management skills across cross-functional teams.

The ideal candidate will manage full project lifecycles, document risks and milestones, and communicate effectively with internal stakeholders and

Qualifications

• Bachelor's Degree or 5+ years working in a managed care healthcare system or health plan.
• 5+ years of Project Management experience with large initiatives.
• 2+ years of Change Management experience.
• Solid understanding of operations, technology, communications, and processes.
• Experience in Claims Lifecycle Initiatives.
• Proficiency in Microsoft Office programs.

Responsibilities

• Plan, organize, monitor, and oversee complex projects using cross functional teams to meet objectives.
• Assist in training and perform duties as the dedicated Project Manager.
• Manage full project life cycle including requirements, plans, budgets, and execution.
• Maintain detailed project documentation and risk management plans.
• Provide leadership and communicate project status to stakeholders and external agencies.
• Negotiate with stakeholders to identify resources and mitigate risks.
• Provide knowledge across multiple business and technical areas.
• Ensure deliverables meet quality standards (design docs, test plans, training materials).
• Lead on-site for project team and motivate members to meet milestones.
• Provide status reporting on milestones, deliverables, dependencies, risks and issues.

Skills

Project management

Change management

Cross-functional

Communication

Microsoft Office

Education

Bachelor's Degree in a related field

Tools

Smartsheet

Jira

Job description

Become a part of our caring community Humana Healthy Horizons is seeking a Medicaid Implementation Senior Project Manager to manage all aspects of a project, from start to finish, so that it is completed on time and within budget. The Medicaid Implementation Senior Project Manager work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. This role mainly focuses on the "Business" side of State Medicaid Implementations with very limited scope in the IT implementation activities. Individuals with business process change management and project management are best suited for this role.

Roles and responsibilities

• Plan, organize, monitor, and oversee complex projects utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.
• Assists in training and perform duties as the dedicated Project Manager.
• Manages the full project life cycle, including review of various sources to assess requirements, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment, and closure.
• Maintains detailed project documentation including meeting minutes, action items, issues lists, project plans, and risk management plans.
• Provides leadership and effectively communicate project status to all stakeholders and external agencies.
• Negotiates with project stakeholders to identify resources, resolve issues, and mitigate risks.
• Provides functional and technical knowledge across multiple business and technical areas.
• Monitors the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.
• Provides on-site leadership for project team by building and motivating team members to meet project goals, adhering to their responsibilities and project milestones.
• Provides status reporting regarding project milestones, deliverable, dependencies, risks and issues, communicating across leadership.
• Understands interdependencies between technology, operations, and business needs.
• Acts as an internal quality control check for the project and participates in quality issue resolution.
• Defines the Statement of Work and Specifications for the requested Medicaid Contract/RFP.
• Sets and continually manages project and program expectations while delegating and managing deliverable with team members and stakeholders.
• Delivers appropriate and effective executive level communication.
• Ensures that projects and programs are proceeding according to scope, schedule, budget, and quality standards.
• Manages project/program issues and risks to mitigate impact to baseline.

Education and Experience

• Bachelor's Degree or 5+ years working in a managed care healthcare system or health plan
• 5+ years of Project Management experience working with large size initiatives
• 2+ years of experience in Change Management
• Possess a solid understanding of operations, technology, communications, and processes
• Experience in Claims Lifecycle Initiatives
• Proficiency in Microsoft Office programs

Knowledge & Technical Skills

• Knowledge of Systems Development Life Cycle, Waterfall, and Agile Development Methodologies
• Experience in business operations or consulting services in a health plan
• Experience with Smartsheet (PM tool) and/or Jira

Certifications

• Prosci, Six Sigma, and/or Project Management Institute certifications

Schedule / Time Zone

Schedule/Time Zone: Remote:Monday through Friday - Typically, 8-5 pm (Eastern Time Zone)Travel Requirements: Up to 10% to Humana office locationWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Compensation

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. 86,300 - $118,700 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Benefits

Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Humana

Humana Inc. (S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employment

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.