Job description
Position Overview:
We are seeking an experienced Project Manager to lead strategic and operational payment integrity initiatives within our healthcare organization. The ideal candidate embodies a proactive, detail-oriented approach to driving project success in a regulated environment and is responsible for managing:
Business projects related to healthcare initiatives (DRG validation, Cost outlier, readmission reviews), and the integration of technology solutions that support these functions.
Cross-functional teams, project timelines, ensuring efficient deployments, and bridging the gap between technical resources, and business operations.
Please be advised that position is in-office Monday to Thursday and remote on Friday.
Responsibilities:
Project Management: Tactically plan, execute, monitor, and close all projects particularly those involving healthcare
Team Coordination: Collaborate with internal teams (IT, Business operations) and external vendors to ensure effective project execution
Requirements Gathering: Work with stakeholders to define scope, requirements, milestones, and resource needs for each project
Scheduling & Budget Tracking: Develop project schedules, track progress, monitor budgets, and manage timelines
Risk & Issue Management: Identify risks and develop mitigation strategies. Escalate issues appropriately to senior leadership or technical teams
Communication: Provide regular updates to project sponsors, stakeholders, and team members. Maintain clear documentation and status reports
Quality & Compliance: Ensure project outcomes comply with healthcare regulations (HIPAA/HITRUST), IT security policies, and internal quality standards
Tracking & Documentation: Monitor all application schedules and document requirements to assure regulatory compliance with HITRUST standards (Privacy framework used by multiple industries to provide data security)
Qualifications:
4+ years’ experience in healthcare project management, and 2+ years’ experience with DRG validation, hospital bill audits, or claims adjudication reviews.
Knowledge of HITRUST, HIPAA, HITECH, and general compliance standards in healthcare/IT.
Proficiency with MS Project, MS Excel (pivot tables, v-lookups), MS Office suite (Excel, Power Point, Word) for documentation/presentations and familiarity with Power BI is a plus.
Deep understanding of ICD-10 coding and healthcare audit practices.
Strong interpersonal skills and ability to communicate effectively both orally and in writing.
Ability to manage competing priorities and influence cross-functional teams.
Organizational and time management skills to keep teams and projects on schedule.
Bachelor’s degree or equivalent experience in health information management, healthcare administration or related field.
Familiarity with payment integrity, claims adjudication, or healthcare fraud/waste/abuse prevention.
Baseline technical knowledge whereby complex technical information is translated for non-technical stakeholders and business goals for technical teams.
Comfortable in a fast-paced healthcare and IT environment requiring adaptability and cross-team collaboration.
Benefits and perks include:
- Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents.
- 401(k) with Employer Match - Join the team and we will invest in your future
- Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you’re not feeling well, and 11 observed holidays.
- Wellness - We care about your well-being. From Commuter Benefits to FSAs we’ve got you covered.
- Learning & Development - Through continued education/mentorship on the job and our investment in LinkedIn Learning, we’re focused on your growth as a working professional.
Salary Range: $110,000 - $125,000/Annually
