Job Summary
We are partnered with an excellent organization that is seeking a skilled Project Manager to lead strategic and operational payment integrity initiatives . This role requires a proactive, detail-oriented professional who can successfully manage projects in a highly regulated environment. The Project Manager will oversee :
- Healthcare business projects, including DRG validation, cost outlier analysis, and readmission reviews, as well as the integration of technology solutions to support these functions.
- Cross-functional teams, project timelines, and deployments, while serving as a liaison between technical resources and business operations.
📌 This is an in-office position Monday through Thursday, with remote work on Fridays.
Key Responsibilities
Project Management : Plan, execute, monitor, and close healthcare-related projects.Team Coordination : Partner with internal teams (IT, business operations) and external vendors to ensure seamless execution.Requirements Gathering : Collaborate with stakeholders to define project scope, requirements, milestones, and resources.Scheduling & Budget Management : Develop project schedules, monitor progress, track budgets, and ensure timely delivery.Risk & Issue Management : Identify risks, create mitigation strategies, and escalate issues when necessary.Communication : Provide clear, consistent updates to stakeholders and leadership; maintain accurate documentation and reports.Quality & Compliance : Ensure all project deliverables meet healthcare regulations (HIPAA / HITRUST), IT security standards, and internal quality benchmarks.Tracking & Documentation : Maintain detailed records to ensure compliance with HITRUST and other regulatory frameworks.Required Skills & Qualifications
4+ years of experience in healthcare project management, with at least 2 years in DRG validation, hospital bill audits, or claims adjudication.Strong knowledge of healthcare compliance standards including HITRUST, HIPAA, and HITECH.Proficiency in MS Project, Excel (pivot tables, VLOOKUPs), Word, and PowerPoint; Power BI experience a plus.In-depth understanding of ICD-10 coding and healthcare audit practices.Excellent communication skills with the ability to convey technical information to non-technical audiences.Strong organizational skills with the ability to manage competing priorities and influence cross-functional teams.Education & Training
Bachelors degree in Health Information Management, Healthcare Administration, or a related field (or equivalent experience).Familiarity with payment integrity, claims adjudication, or healthcare fraud / waste / abuse prevention.Technical aptitude to bridge business needs with IT solutions in a fast-paced, collaborative environment.