Medicare Programs Project Manager

Job Number: 2453

Workplace Type:

Position Title: Medicare Programs Project Manager

External Description:

This position requires significant knowledge of health plan operations and individual must have previous experience working with health plan operations especially Retention, Marketing, Sales. This position will be primarily supporting the Retention and Marketing program and will be helping to develop a framework to help improve retention of health plan members more effectively. 

 

• Retention Project manager will be responsible for ensuring program activities are completed in a high quality and timely manner and ensuring compliance with all regulatory guidelines such as Medicaid (Medi-Cal) and Medicare
• Partner with various departments to support Retention Program
• Perform member meetings during Town halls, etc
• Knowledge of health plan operations including Marketing, Sales, eligibility, claims, Medi-Cal, Medicare, Network, IPA-Model, SNP Model of Care, Products, among others
• Manages the creative intake process, creates project timelines, monitors project life-cycle from start to finish
• Implement new programs and workflows
• Works with marketing colleagues and creative teams to facilitate successful delivery of marketing collateral
• Ability to gain and maintain comprehensive knowledge of a CRM and Salesforce Marketing Cloud system to intake work, develop timelines, manage workflow, monitor project status and develop solutions to unexpected issues when they surface
• Initiates project by working with sponsor(s) to develop project scope including goals, objectives, milestones, and deliverables.
• Works with the project sponsor(s), business manager, functional managers in gathering business requirements, current state assessments and/or project requirements to develop preliminary project documents.
• Works with strategic project stakeholders to develop and oversee project status reports including: key accomplishments, risks, issues, action items, upcoming activities, deliverable examples, etc.
• Lead project status update meetings with the strategic project Operating Committee.
• Executes the project by leading the work of the project resources (internal and/or external) in a matrix environment.
• Ensures project team is actively participating, collaborating and coordinating among team members as well as with other projects and/or business operations.
• Performs business analyst functionalities including: documenting future state business and technical requirements, documenting future state process flow diagrams, developing design documents, etc.
• Monitors and controls all aspects of the project by measuring progress and correcting course when project goes beyond scope or is not meeting goals and objectives.
• Ensures project remains on timeline by managing schedules and resources and removing barriers.

 

Must have

• Bachelor’s degree in health care, business administration, or related field of study (or equivalent work experience) required.
• 5+ years of Health Plan Project Management Experience working with Medi-Cal or Medicare programs
• Proficient with the use of Word, Excel, PowerPoint, Visio, Project and other Microsoft Office Suite products.
• Project Management Certificate
• Excellent presentation skills
• Moderate to strong skills in quantitative analysis (including SQL), qualitative analysis, and problem-solving.

 

City: Orange

State: California

Location City: Orange

Location State: California

Community / Marketing Title: Medicare Programs Project Manager

Company Profile:

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

EEO Employer Verbiage:

 

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].