Remote Medicaid Implementation Senior PM

Humana, Inc.; Frankfort (KY); Remote; USD 86,000 - 119,000; Full time

Job summary

Humana Healthy Horizons seeks a Medicaid Implementation Senior Project Manager to lead end-to-end delivery of complex state Medicaid initiatives, focusing on business processes with limited IT scope. You will plan, monitor, and close projects across cross-functional teams, ensuring on-time, on-budget results and strong stakeholder communication.

The role requires 5+ years in managed care project management, experience with Medicaid/Medicare, and proficiency in MS Office; remote work with up to

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 size initiatives.
• 2+ years of experience in Change Management.
• 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.

Responsibilities

• Plan, organize, monitor, and oversee complex projects utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.
• Assist in training and perform duties as the dedicated Project Manager.
• Manage the full project life cycle, including review of sources to assess requirements, create project plans and schedules, obtain and manage resources, manage budget, and facilitate execution.
• Maintain detailed project documentation including meeting minutes, action items, issues lists, plans, and risk management plans.
• Provide leadership and communicate project status to stakeholders and external agencies.
• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.
• Coordinate cross-functional meetings with various functional areas to meet stakeholder expectations.
• Provide functional and technical knowledge across multiple business and technical areas.
• Monitor creation of deliverables to ensure quality standards (design docs, test plans, training materials, operations docs).
• Provide on-site leadership for project team to meet milestones and responsibilities.
• Work creatively and analytically in a problem-solving environment with teamwork and excellence.
• Provide status reporting on milestones, deliverables, dependencies, risks and issues across leadership.
• Understand interdependencies between technology, operations, and business needs.
• Act as quality control check for the project and participate in issue resolution.
• Define the Statement of Work and Specifications for Medicaid Contract/RFP.
• Set and manage expectations while delegating deliverables with team members.
• Deliver executive level communication.
• Ensure projects and programs proceed according to scope, schedule, budget, quality.
• Manage issues and risks to protect baseline.

Skills

Project management

Change management

MS Office

Medicaid/Medicare experience

Operations understanding

Communications

Claims lifecycle initiatives

Education

Bachelor's Degree

5+ years managed care experience

Tools

Smartsheet

Jira

Job description

Humana Healthy Horizons seeks a Medicaid Implementation Senior Project Manager to lead end-to-end delivery of complex state Medicaid initiatives, focusing on business processes with limited IT scope. You will plan, monitor, and close projects across cross-functional teams, ensuring on-time, on-budget results and strong stakeholder communication.

The role requires 5+ years in managed care project management, experience with Medicaid/Medicare, and proficiency in MS Office; remote work with up to