Operations Project Manager

Genuine Health Group LLC•Coral Gables, FL

About The Position

The Project Manager will lead administrative efforts to drive improvements in physician engagement, quality, revenue, cost, and clinical programs. This role encompasses managing network operation projects, enhancing engagement through physician incentives, and ensuring compliance with healthcare contracts. The individual will serve as a centralized operations point person for all network initiatives, including payer relations, and collaborate closely with department leads in Physician Engagement, Clinical, Revenue, and Quality. Additionally, they will facilitate the credentialing process and manage the contract lifecycle, ensuring all agreements are accurate and compliant. The Project Manager will also collaborate with other company leaders, as needed, that sit outside of the Operations Division, such as for Finance, Strategy, Data & Analytics, Growth & Retention, etc.

Requirements

5 years of experience in a healthcare-related position, preferably managed care environment and/or Bachelors' Degree in a health-related field or Business Administration or equivalent combined experience.
2-3 years project management in a health care setting is preferred.
Excellent communication skills and ability to communicate effectively with all levels of the organization, both written and verbal
Ability to gather and analyze information and communicate to others
Analytical, problem-solving, and troubleshooting skills
Project management, time management and organizational skills
Ability to work well with others and work in a team environment
Dynamic presentation skills
Pays close attention to detail, is resourceful and highly dependable
High energy level; comfortable performing multiple projects in conjunction with day- to-day activities
Strong listening skills required to gather requirements and understand barriers to project completion
Bilingual: Spanish and English.
Proficient in MS Office programs (i.e., Word, Excel, Outlook, Access, and Power Point). Advanced proficiency in Excel and PowerPoint

Nice To Haves

Prior experience and/or knowledge of HEDIS, CMS Star Rating System, and/or Medicare Risk Adjustment is preferred.
Prior experience and/or knowledge of CMS and Medicare Advantage payment methodologies, and Value-Based Contracting is preferred.

Responsibilities

Plan, organize, manage, and monitor projects and initiatives utilizing cross-functional teams to meet strategic objectives.
Coordinate and facilitate meetings, including operational workgroups and regular touchpoints.
Collect data from departments and prepare reports on key performance indicators for stakeholders.
Identify opportunities to improve internal and external processes and reporting.
Track and analyze data to evaluate the impact on operational objectives and performance metrics monthly.
Support department leads by creating detailed project plans based on established requirements and timelines.
Serve as the centralized point for reporting and analysis requests; collaborate with the Data Analytics team to track progress and troubleshoot issues.
Prepare, review, and execute healthcare contracts, including provider agreements for various health plans, ensuring accuracy and compliance.
Maintain a centralized contract repository, organizing documents and tracking deadlines and renewals.
Conduct credentialing as required by payor contracts, including Medicare.
Develop presentation materials for meetings with internal and external participants.
Provide regular project and initiative status updates to team members and follow up on action items.
Support the Operations division as needed; other duties may be assigned.