Sr. Program Manager - Healthcare Enrollment (Remote)

Lensa; Dayton (OH); Remote; USD 77,000 - 172,000; Full time

Job summary

A leading company in IT Services and Consulting is seeking a Program Manager to oversee enrollment-related projects. The role requires strong analytical and organizational skills, with responsibilities including project delivery, compliance, and vendor oversight. Candidates should have a Bachelor's degree, relevant experience, and certifications like PMP.

Qualifications

• 7-9 years of experience required; 10+ years preferred.
• PMP certification required; Six Sigma Black Belt and ITIL preferred.
• Experience with eligibility processing and health insurance.

Responsibilities

• Manage and deliver enterprise-wide enrollment projects.
• Serve as a subject matter expert in enrollment processes.
• Ensure compliance with regulations and address health plan concerns.

Skills

Analytical skills

Organizational skills

Project management

Regulatory compliance

Process improvement

Education

Bachelor's Degree

Job description

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Job Summary

Responsible for managing multiple enrollment-related projects and programs involving department or cross-functional teams. The role includes designing, developing, and overseeing project delivery, reviewing ROI, troubleshooting, and managing assignments. The position requires strong analytical and organizational skills, with the ability to resolve issues independently. It is a hybrid role combining Program Management, System Analysis, and Senior Business Analysis, including vendor oversight, deployment review, and post-deployment monitoring.

The candidate will act as a liaison among business units, vendors, IT, and support teams, providing subject matter expertise. Responsibilities include requirements gathering, testing, and ensuring regulatory compliance, particularly related to Medicaid and Medicare processes.

Knowledge/Skills/Abilities

• Manage and deliver enterprise-wide enrollment projects from inception to completion
• Serve as a subject matter expert in enrollment processes for Program Managers and Analysts
• Collaborate with Operations, Health Plans, and Leadership to translate needs into functional requirements
• Develop and monitor project plans, schedules, and deliverables
• Identify root causes and opportunities for process improvements
• Lead programs addressing critical needs, including BRD reviews and logic changes
• Work with operational leaders to recommend process improvements
• Coordinate with cross-functional teams, including IT and external vendors, to deliver end-to-end solutions
• Ensure compliance with regulations and address health plan concerns within Enrollment Operations
• Research, interpret, and summarize enhancement recommendations
• Manage deliverables, performance improvements, and training
• Possess strong knowledge of Medicaid and Medicare lines of business
• Review enrollment issue trends and develop long-term solutions
• Communicate project status effectively
• Ensure adherence to HIPAA and other regulatory guidelines

Qualifications

Education: Bachelor's Degree or equivalent experience

Experience: 7-9 years required; 10+ years preferred

Certifications: PMP required; Six Sigma Black Belt and ITIL preferred

Additional qualifications include experience with eligibility processing, health insurance, enrollment files, and program management.

Additional Information

Position is full-time, Mid-Senior level, in the IT Services and Consulting industry. Salary range: $77,969 - $171,058 annually, with actual compensation based on location and experience. Interested employees should apply via the intranet.