Sr Project Manager
Posting ID: JP-002147185
CareFirst BlueCross BlueShield is looking to make a massive investment into the Medicare/Medicaid Advantage markets in an effort to better support the customers and provide a higher level of care. CareFirst quickly made an investment in Medicaid by urchasing 2 companies in Maryland and Washington DC to expedite their business goals.
CareFirst has decided to build and implement a Medicare Advantage program from the ground up and are in need of outside expertise to assist with this multi million dollar effort. This is being pushed directly by the CEO as a top priority for their organization as they are losing market share once their customers reach eligibility for Medicare.
This Sr Project Manager must have excellent Business knowledge and experience in implementing Medicare Advantage for another BCBS plan OR another health insurance company. They will be a go to person for this implementation as they do not have the expertise in house as this is their first time offering this program.
- Responsible for the design, implementation, and operations of employer group Medicare Advantage functions, ensuring smooth operations between CareFirst and the vendor partners.
- Coordinates with the Business and IT teams of the program implementation
- Oversees and evaluates operational programs policies and procedures to ensure compliance with all CMS and state regulations and external accreditation standards pertaining to or affecting Medicare Advantage operations.
- Manages projects, develops, and directs technical project teams through all phases and activities of the project life-cycle process associated with major information technology systems projects that are essential to departmental missions and affect corporate operations on a long-term and continuing basis.
- Determines Project goals and priorities with management, program manager and/or project sponsors.
- Supports requirements of the enterprise program manager to provide necessary information and support for successful program delivery.
- Creates all project planning documentation and follows all corporate Defined processes.
- Manages and communicates a clear vision of the projects objectives and motivate the cross functional project team to achieve them; create a project environment that enables peak performance by the entire team.
- Establish and publish clear priorities among project activities. Coordinates team activities to meet project milestones.
- Directs/leads project teams comprised of subject matter experts, technical specialists, and support staff to produce a business plan in accordance with the strategic plan, operating budget, capital planning procedures and agency guidance.
- Prepares, implements, monitors, and updates the project plan. Coordinates with the business owner and upper-level management to ensure the actions are consistent with the approved plan.
- Identifies standards or requirements for change management. Participates in change control (for example, reviewing configuration change requests).
- Develops or implements information systems security and entitlement requirements and plans; and ensures appropriate product-related training and documentation are developed and made available to customers.
- Manages resource assignment and tracking to the project plan and project schedule in coordination with the line of business resource managers.
- Negotiate the performance of activities with team members and their managers in a matrix environment.
- Coach to clarify assignments and deliverables; mentor others in project management practices; review quality of work and manage the integration of team members' work. Manages the Project Budget with overall budget accountability for up to $4 million per year.
- Collaborates with the finance department and various functional managers to ensure project budgets are properly estimated and controlled; provides overall financial recommendations and develop controls and measurements to monitor progress.
- Provides Finance with monthly accruals and forecasts by the due date established by Finance using the tools developed by Finance.
- Maintains current statements of work for all contractors; track and approve contractor invoices in a timely manner.
- Provides regular updates to project sponsor and stakeholders on the status of the budget.
- Documents reasons for budget excess or shortfall.
- Manages project budgets for both expense and capital against the original project budget.
- Creates Executive Summaries for all contractor resources required to complete a project.
- 5-7 years of project or program management and/or consulting experience in healthcare or related environment, with a least 3 years work experience with Medicare Advantage.
- Subject matter expertise on Medicare Advantage rules and regulations as they apply to operations or EGWP programs
- Ability to act as project lead on dynamic, multidisciplinary high-performance work teams to find creative solutions that optimize program goals and performance.
- Expert ability to synthesize complex data and analysis into clear, concise communications. Experience in developing executive level presentations and reports on strategic initiatives.
- Strong interpersonal skills, with the ability to communicate and influence others.
- Excellent oral and written communications; an ability to present and discuss analytical and technical information in a way that establishes rapport, persuades others, and gains understanding.
- Strong management, business planning, and organizational skills.
- Demonstrated proficiency with multiple reporting applications and tools, including MS Excel, Access, Word, PPT and Project.
- Knowledge of vendor management, including development of RFPs and SOWs and the tracking and monitoring of service level agreements.
- Knowledge of the health insurance industry and current and emerging health and wellness trends.
- Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
Project management, Pmp, Waterfall, Stakeholder management, Health care, Project plan, medicare, medicare advantage, Resource planning, Program management, Reporting, implementation, integration, budget, ms project, vendor management
Top Skills Details:
Project management,Pmp,Waterfall,Stakeholder management,Health care,Project plan,medicare,medicare advantage
Additional Skills & Qualifications:
They need this Sr. PM to take ownership and provide a consulting mindset while being able to work with small amount of direction. This individual is being brought in to take bring subject matter expertise on a large scale Medicare Advantage program that is being driven by the CEO of CareFirst.
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Recruiter: Jean Chambers
Phone: (410) 579-3072