Project Manager (Clinical-Payer)

Job Details

Sr Mgr,Project Prog Mgt (IC)

Primary Location: Hybird

Position Summary
Leads and oversees the planning, execution, and successful completion of projects with business enablement focus by establishing the operational plan (project scope, objectives, and timelines) allocating resources, and managing project budgets from initiation through completion. Collaborates with cross-functional teams, communicates project progress to stakeholders, and uses formal processes and tools to manage resources, budgets, risks, and changes to ensure projects are delivered on time and within budget while meeting quality standards. This individual contributor role blends expertise in stakeholder engagement and collaboration, requirements development and analysis, and business readiness testing with program, project and risk management expertise with a primary focus on Clinical Care Management (CCM) user acceptance testing (UAT).  The ideal candidate will have experience in care management programs, processes, and systems, and will serve as a strategic partner to business and technology stakeholders.

Leads and oversees the planning, execution, and successful completion of projects with a business enablement focus by defining project scope, objectives, and timelines from initiation through completion. Collaborates with cross-functional teams, communicates project progress to stakeholders, and uses formal processes and tools to manage business enablement requirements and actions, risks, and changes to ensure projects are delivered on time and within budget while meeting quality standards. This individual contributor role blends expertise in stakeholder engagement and collaboration, requirements development and analysis, and UAT with project and risk management expertise.  The ideal candidate will have experience in care management programs, processes, and systems, and will serve as a strategic partner to business and technology stakeholders.

Role Responsibilities:

• Allocates accountability by assigning clear responsibilities and expectations to project team members, ensuring effective project execution.
• Analyzes the organization's project management practices, identifying areas for improvement and implementing strategies to enhance project efficiency and success.
• Approves project plans, budgets, and deliverables, ensuring alignment with organizational objectives and stakeholder expectations.
• Attends project meetings and collaborates with multiple departments, fostering cross-functional collaboration and coordination to achieve project milestones.
• Communicates direction and project goals to the project team, providing clear guidance and ensuring alignment with strategic objectives.
• Conducts project evaluations and assessments, monitoring progress, identifying risks and issues, and taking corrective actions to keep projects on track.
• Consolidates information from various sources, synthesizing project data and insights to provide comprehensive reports and updates to stakeholders.
• Lead strategic discussions with business units, platform teams, operations, vendors, and external partners to gather insights and guide clinical system requirements.
• Elicit and analyze data to shape functional and non-functional requirements, ensuring alignment with business goals, user needs, and healthcare regulations (e.g., HIPAA, CMS, state, and group contracts).
• Create detailed end user system capability maps for internal and external users (e.g., members, providers, care managers) to visualize system interactions, decision points, and dependencies using insights to inform product design, testing, and implementation strategies that enhance user experience and system clarity.

o    Develop and maintain system job aids consisting of clear, sequential instructions on how to perform actions within clinical systems translating complex system processes into clear, user-friendly guidance aligned to real-world business operations; ensuring accuracy, traceability to requirements, and usability for training, UAT support, and as day-to-day quick reference support.

• Define User Acceptance Test scenarios and business acceptance criteria in support of UAT as well as End-to-End testing; design and author test scripts; identify and document defects; and collaborate with product and development teams to ensure resolution.

o    Defines business UAT scenarios and business acceptance criteria authors test scripts; documents defects; defines and develops standardized scripts for use by all script developers use; partners with product and development teams to ensure resolution prior to Clinical Care Management UAT execution

• Support system implementations by contributing to training, communication, and change management efforts.
• Support and monitor post-launch performance and drive continuous improvement.

Required Qualifications

• 7-10 years work experience preferably working on healthcare IT initiatives.
• Adept at development, execution and delivery (planning, delivering, and supporting) skills
• Adept at business intelligence, collaboration, and teamwork
• Mastery of problem solving, decision making, and growth mindset (agility and developing yourself and others) skills
• Strategic thinker with a hands-on approach to execution in a regulated healthcare setting.
• Proven ability to work independently, manage multiple complex priorities, and deliver results in a fast-paced, dynamic environment.
• Experience with Agile, Scrum, or hybrid delivery frameworks.
• Excellent facilitation, communication, and stakeholder management skills. Able to influence across clinical, operational, and IT teams.
• Familiarity with enterprise health platforms, digital tools, and user testing frameworks.

Education

• Bachelor's degree preferred/specialized training/relevant professional qualification.

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