Project Manager (Healthcare)

Job Description

Job Description

We are looking for a skilled Healthcare Project Manager to lead critical initiatives within the payment integrity domain. This role requires a strategic thinker with a strong background in healthcare operations and project management, capable of driving cross-functional collaboration and ensuring compliance with industry regulations. The ideal candidate will excel in managing complex projects while delivering impactful solutions that align with organizational objectives.

Responsibilities :

• Manage and oversee healthcare projects, including validation processes, cost analysis, and readmission reviews, ensuring they meet organizational goals and compliance standards.
• Coordinate the implementation of technology solutions that enhance payment integrity functions, collaborating closely with IT and business teams.
• Facilitate communication and collaboration across departments such as IT, clinical operations, and finance to ensure seamless project execution.
• Develop comprehensive project plans, including scope definition, timeline creation, resource allocation, and progress monitoring for successful delivery.
• Identify and address project risks, creating mitigation strategies and escalating issues as needed to maintain project continuity.
• Provide stakeholders and sponsors with regular updates, maintaining clear documentation and enabling informed decision-making.
• Ensure adherence to healthcare regulations and compliance standards, including HIPAA and HITRUST, throughout all project activities.
• Translate technical requirements into actionable business strategies, ensuring alignment between technical solutions and organizational needs.
• Minimum of 4 years of project management experience within the healthcare industry.
• At least 2 years of experience with validation processes, claims adjudication, or hospital bill audits.
• Strong knowledge of compliance frameworks such as HIPAA, HITRUST, and healthcare audit practices.
• Proficiency in Microsoft Project, Excel (including pivot tables), PowerPoint, and Word; familiarity with Power BI is advantageous.
• Understanding of DRG coding and payment integrity principles.
• Exceptional communication and interpersonal skills, with the ability to manage competing priorities effectively.
• Proven track record in leading cross-functional teams and driving project success.
• Bachelor’s degree in Healthcare Administration, Health Information Management, or a related field, or equivalent relevant experience.