Job Title: Project/Program Manager II (Non-IT)
Request ID: 69242-1
Start Date: April 21, 2025
End Date: December 31, 2025
Location: Remote - Must reside in AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY, OH, TX, UT, WA or WI
Work Hours: Monday – Friday, 8:00 AM – 5:00 PM PST
Employment Type: Contract - to -Permanent - up to $55/hour
Industry: Managed Care
A managed care organization is seeking a Project/Program Manager II (Non-IT) to support internal and external initiatives related to delegated Utilization Management and Claims reporting. This fully remote role is ideal for professionals with prior experience in managed care, strong communication and organizational skills, and a solid foundation in Microsoft Office tools.
IPA Report Tracking: Monitor and manage incoming IPA reports.
Stakeholder Communication: Send communications and provide education to delegated provider groups on reporting protocols.
File Management: Ensure appropriate teams receive files for manual system entry.
Claims Tracking: Oversee and track pending claims while educating delegated groups.
Troubleshooting: Identify and resolve delegate submission and reporting issues.
Project Management:
Lead mid-to-large-scale business projects through their full lifecycle.
Define scope, schedule, resources, costs, risks, and quality.
Develop and maintain detailed project documentation including plans, schedules, workflows, and status reports.
Conduct regular status meetings, track milestones, and ensure timely delivery.
Collaborate with various departments, including health plan operations and external partners.
Process Development: Create and refine process workflows for operational improvements.
Education: Bachelor’s degree
Experience:
2–4 years of formal project management experience
2–4 years of experience in systems implementation
Experience working within or supporting managed care operations (UM or Claims)
Familiarity with health plan operations and reporting processes
Proficient in Microsoft Office Suite, including Excel, Word, Project, PowerPoint, and Visio
Excellent written and verbal communication
Strong problem-solving and analytical skills
Ability to lead cross-functional project teams
Attention to detail and organizational skills
Knowledge of health plan product lines and performance metrics
Comfortable working independently and as part of a team