Encounter SR. Project manager

CVS Health•Phoenix, AZ

1d•$67,900 - $182,549•Hybrid

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. The Sr. Manager Project Program Management (Sr. Project Manager) serves as the plan and state liaison related to encounter creation, submission, and resolution. Independently oversees day-to-day activities to ensure compliance with state contractual requirements for encounter submissions. Accountable for monitoring daily workflow / activities including subcontracted vendors, revenue priorities and initiatives or projects. Leads the team in setting priorities while executing toward department goals. Drives overall team results in addition to continuous process improvements. Supports leadership with hiring, onboarding, training, and development of staff. Independently leads routine and high visibility projects related to regulatory requirements, encounter system enhancements, conversions, and implementations. Leads and coordinates activities surrounding new business /expansions including the development of business/resource requirements, test plans, and documentation. Delegation of work assignments based on business needs. Initiates root cause analysis and collaborates with internal departments to develop solutions that impact encounter acceptance. Work with State/Federal regulators to define contractual requirements, remove barriers and resolve encounter rejections. Develop effective relationships with State/Federal regulators as well as all levels of internal leadership. Monitor subcontracted vendors performance and address deficiencies. Present technical information in a meaningful manner to internal and external stakeholders. Facilitate meetings, prepare, and update project plans, agendas, and meeting minutes. Evaluate existing processes to identify opportunities to improve efficiency by developing and executing strategic plans. Provide coaching, developmental feedback and mentorship to team members. Tracks progress and communicates team performance and project status on a regular basis to leadership and business partners.

Requirements

7+ years of healthcare experience
3+ years of leadership or project management experience.
3+ years of data interpretation/analysis experience and demonstrated ability to make sound decisions with available data. (SQL, Excel, Tableau)
Strong verbal/written communication skills.
Strong organizational skills and ability to independently coordinate multiple projects and priorities.
Ability to translate technical requirements/processes to business partners.
Medical/Pharmacy claim/encounter experience.

Nice To Haves

EDI File experience.
Experience in Health Care or Medicaid.
Familiarity and/or certification in Agile Methodology.
SQL programming.
Inventory management experience.

Responsibilities

Serves as the plan and state liaison related to encounter creation, submission, and resolution.
Independently oversees day-to-day activities to ensure compliance with state contractual requirements for encounter submissions.
Accountable for monitoring daily workflow / activities including subcontracted vendors, revenue priorities and initiatives or projects.
Leads the team in setting priorities while executing toward department goals.
Drives overall team results in addition to continuous process improvements.
Supports leadership with hiring, onboarding, training, and development of staff.
Independently leads routine and high visibility projects related to regulatory requirements, encounter system enhancements, conversions, and implementations.
Leads and coordinates activities surrounding new business /expansions including the development of business/resource requirements, test plans, and documentation.
Delegation of work assignments based on business needs.
Initiates root cause analysis and collaborates with internal departments to develop solutions that impact encounter acceptance.
Work with State/Federal regulators to define contractual requirements, remove barriers and resolve encounter rejections.
Develop effective relationships with State/Federal regulators as well as all levels of internal leadership.
Monitor subcontracted vendors performance and address deficiencies.
Present technical information in a meaningful manner to internal and external stakeholders.
Facilitate meetings, prepare, and update project plans, agendas, and meeting minutes.
Evaluate existing processes to identify opportunities to improve efficiency by developing and executing strategic plans.
Provide coaching, developmental feedback and mentorship to team members.
Tracks progress and communicates team performance and project status on a regular basis to leadership and business partners.