Program Manager - Encounters

Ohio Operation Lead On Claims And Encounters

Supporting the Ohio Health Plan, the candidate will act as the Ohio Operation lead on Claims and Encounters as well as the liaison to our state regulator in these areas. This is not a developer role but the candidate must be technically inclined and interface with IT, Claims, and Encounter Teams. Must be a self-starter willing to learn. Must be a good communicator, comfortable speaking up in group discussions and love work collaboratively with other teams and with senior leadership. This role involves research, root cause analysis, sharing recommendations, analyzing reports and other duties as specified. Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project / program management.

Job Duties

Active collaborator with people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion.

Plans and directs schedules as well as project budgets.

Monitors the project from inception through delivery.

May engage and oversee the work of external vendors.

Focuses on process improvement, organizational change management, program management and other processes relative to the business.

Leads and manages team in planning and executing business programs.

Serves as the subject matter expert in the functional area and leads programs to meet critical needs.

Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements. Delivers the appropriate artifacts as needed.

Works with operational leaders within the business to provide recommendations on opportunities for process improvements.

Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.

Generate and distribute standard reports on schedule

Job Qualifications

Required Education : Bachelor's Degree or equivalent combination of education and experience.

Required Experience / Knowledge, Skills & Abilities :

3-5 years of Program and / or Project management experience.

Operational Process Improvement experience.

Healthcare experience.

Experience with Microsoft Project and Visio.

Excellent presentation and communication skills.

Experience partnering with different levels of leadership across the organization.

Preferred Education : Graduate Degree or equivalent combination of education and experience.

Preferred Experience :

5-7 years of Program and / or Project management experience.

Managed Care experience.

Experience working in a cross functional highly matrixed organization.

Preferred License, Certification, Association :

PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification and / or comparable coursework desired.