This is a fully remote position, open to applicants in Missouri.

📋 Description

• Supervise the integration of products and strategies within the Claims business units.

• Ensure alignment with organizational strategies and objectives, maintaining consistency in implementation processes, methodologies, and models.

• Lead the development and upkeep of standard models for the claims implementation strategy.

• Oversee all Claims and Configuration Operations activities throughout the implementation phase.

• Provide strategic direction and oversight for the implementation processes within the claims business.

• Ensure compliance with standard implementation procedures and collaborate on the approval of Business Requirements Documents with the Claims Process Owner.

• Contribute to the development of operating models, corporate functional and information system frameworks, performance metrics, anticipated outcomes, and plan impacts.

• Direct claims business implementations to fulfill budget, timeline, and scope necessities.

• Offer insights into business planning and establish timelines for New Health Plan Business Implementations.

⛳️ Requirements

• Bachelor’s degree in a related discipline or equivalent experience.

• Master’s degree is preferred.

• Over 7 years of experience in project management.

• In-depth knowledge and experience in applying project management methodologies and tools.

• More than 5 years of experience in Government Programs Managed Care across various Operations areas, including Claims, Provider/Mbr Services, Medical Management, or Network.

• Experience in Medicaid Managed Care is preferred.