Description
We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.
The Senior Manager, Project Management is responsible for leading and overseeing Coordination of Benefits projects and operational initiatives that improve payment accuracy, reduce overpayments, enhance compliance, and drive process efficiency across the organization.
This role manages a portfolio of complex, cross-functional projects and collaborates with stakeholders across Claims, Enrollment, Provider Services, Operations, Technology, Analytics, and Vendor Management to ensure successful delivery of strategic business objectives.
The Senior Manager is accountable for defining project scope, objectives, timelines, resource requirements, and success measures while ensuring initiatives are delivered on time, within budget, and aligned with organizational goals.
Financial Performance & Affordability Leadership
- Own strategic affordability initiatives, savings programs, recovery opportunities, and payment accuracy improvements.
- Lead financial impact assessments, forecasting activities, variance analysis, savings validation, and return-on-investment evaluations.
- Develop and monitor performance metrics measuring operational effectiveness, recoveries, cost avoidance, provider impact, and financial outcomes.
- Establish performance objectives, implementation priorities, operating plans, and long-term growth strategies.
- Oversee multiple concurrent initiatives while ensuring alignment with organizational goals, timelines, quality requirements, and financial targets.
Required Qualifications
- 5+ years of leadership experience managing teams, including performance management, coaching, employee development, and workforce planning.
- 7+ years of experience in Payment Integrity, Healthcare Operations, claims administration, Coordination of Benefits, Medicare, Commercial Insurance, or related healthcare functions.
- Demonstrated experience leading large-scale, cross-functional projects and operational transformation initiatives.
- Strong knowledge of healthcare claims processing, COB regulations, Medicare Secondary Payer guidelines, NAIC rules, and related payment integrity processes.
- Experience developing and implementing business process improvements that reduce operational costs, improve quality, and enhance customer satisfaction.
- Experience working with healthcare technology platforms (ACAS, HRP), reporting tools, and data visualization solutions such as, Power BI, Tableau, Quickbase, or similar applications.
Preferred Qualifications
- Demonstrated ability to collaborate effectively with executive leadership, operational teams, vendors, providers, and external business partners.
- Experience leading organizational change management initiatives and driving adoption of new processes, workflows, and technologies.
- Exceptional written and verbal communication skills, including experience presenting complex information and recommendations to senior leaders.
- Knowledge of vendor management, offshore operations, workflow management, and performance metric development is strongly preferred.
Education
- Bachelor's degree preferred; equivalent combination of education and relevant experience may be considered.
Pay Range
- $67,900.00 - $199,144.00
Benefits
- Medical, dental, and vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources, based on eligibility