Medicaid Implementation Senior Project Manager

Humana; North Carolina; Remote; USD 86,000 - 119,000; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

Humana Healthy Horizons is seeking a Medicaid Implementation Senior Project Manager to oversee complex state Medicaid projects, driving on-time, on-budget delivery with cross-functional teams. The role emphasizes the business side, guiding requirements, plans, and stakeholder communications with limited IT work.

Ideal candidates have strong change management and project leadership skills, plus experience in Medicaid/Medicare and claims lifecycle initiatives. Remote-friendly with travel up to 10%.

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 Medicaid and/or Medicare.
• Experience in Claims Lifecycle Initiatives.
• Proficiency in Microsoft Office programs.

Responsibilities

• Plan, organize, monitor, and oversee complex projects with cross-functional teams.
• Manage full project life cycle including plans, schedules, resources, budget, execution and closure.
• Maintain detailed project documentation and risk management plans.
• Provide leadership and communicate project status to stakeholders and agencies.
• Negotiate resources, resolve issues, and mitigate risks.
• Coordinate cross-functional meetings to meet stakeholder expectations.
• Ensure adherence to quality standards across deliverables.
• Provide on-site leadership to motivate the team toward milestones.
• Ensure projects proceed within scope, schedule, budget, and quality.
• Handle issues and risks to protect the baseline.

Skills

Project Management

Change Management

Medicaid/Medicare experience

Microsoft Office

Operations understanding

Vendor coordination

Education

Bachelor's Degree or 5+ years managed care

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.

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.

The Medicaid Implementation Senior Project Manager 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.
• Coordinates cross-functional meetings with various functional areas to meet overall stakeholder expectations and company’s objectives.
• 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.
• Works creatively and analytically in a problem-solving environment demonstrating teamwork, innovation, and excellence.
• 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.

Required Qualifications

Use your skills to make an impact

• 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 working in Medicaid and/or Medicare.
• Experience in Claims Lifecycle Initiatives.
• Proficiency in Microsoft Office programs.

Preferred Qualifications

• 2+ years of leadership experience in a matrixed environment
• 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
• Experience in Process mapping and workflow design
• Experience Identifying root causes and control gaps
• Prosci, Six Sigma, and/or Project Management Institute certifications.

Additional Information

• Schedule/Time Zone: Remote: Monday through Friday - Typically, 8-5 pm (Eastern Time Zone)
• Work Location: US Nationwide
• Travel Requirements: Up to 10% to Humana office location

Work 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: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; 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. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

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. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$86,300 - $118,700 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description Of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. 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 Us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.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. Learn more about what we offer atHumana.comand atCenterWell.com.

Equal Opportunity Employer

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.