Program Manager III – Provider Data Operations

This is a fully remote position, open to applicants in California, +14 more states.

📋 Description

• Enhance program efficiency, service quality, and value by capturing, monitoring performance, and pinpointing areas for improvement.

• Strategically plan, organize, oversee, and lead multiple concurrent projects utilizing cross-functional teams.

• Direct the planning, execution, governance, and delivery of intricate Mission Simplify initiatives that support the transformation of Provider Data Operations.

• Propel initiatives from the discovery phase through to implementation and operational transition.

• Recognize opportunities to boost efficiency, elevate service levels, ensure compliance with regulations, and optimize operations.

• Formulate strategies for improvement opportunities, prioritize organizational needs, align resources, and meet strategic business goals.

• Manage projects through the discovery phase, requirements gathering, scope definition, planning, resource management, budget oversight, implementation, deployment, and transition.

• Create integrated project plans, milestones, dependencies, RAID logs, and executive status reports.

• Sustain project documentation, such as action items, issue logs, risk mitigation strategies, business requirements, acceptance criteria, and testing readiness documentation.

• Convey project status through executive summaries, dashboards, presentations, and governance updates.

• Negotiate for resources, address issues, mitigate risks, and achieve stakeholder alignment along with formal scope approval.

• Facilitate cross-functional meetings and governance routines with Business Analysts, Subject Matter Experts (SMEs), technology teams, operational leaders, and business partners.

• Deliver functional and technical expertise regarding program requirements, operational processes, and the implementation of business solutions.

• Monitor project health and KPIs, identify risks and issues, and devise mitigation strategies.

• Assist with change management, training readiness, stakeholder communications, and activities related to operational transition.

• Establish and advocate for project management standards, tools, templates, and best practices.

⛳️ Requirements

• Bachelor’s degree in Business Administration, Healthcare Administration, a related field, or equivalent experience.

• Master’s degree is preferred.

• Over 5 years of project implementation, product, or program management experience.

• Experience in managed care or prescription benefit management is preferred.

• Background in healthcare payer, provider operations, provider data management, network operations, or health plans.

• Proficient in Smartsheet, Jira, Power BI, Microsoft Office Suite, and collaboration platforms.

• PMP, PgMP, Lean Six Sigma, Agile, Scrum, or similar certifications.

• Experience in leading process improvement, automation, digital transformation, or redesigning operating models.

• Knowledge of provider credentialing, provider data management, enrollment operations, network management, or healthcare operations.

• Proven experience supporting large-scale strategic transformation programs with measurable operational and financial outcomes, including the ability to present to senior leadership and influence decision-making across multiple business functions.

• Demonstrated experience leading enterprise-wide and cross-functional initiatives involving multiple stakeholders.

• Solid experience managing project plans, requirements, risks, dependencies, budgets, and executive communications.

• Proficient in facilitating requirements workshops, stakeholder engagement sessions, and governance reviews.

• Familiarity with project management methodologies and delivery frameworks.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase plan.

• Tuition reimbursement program.

• Paid time off in addition to holidays.

• Flexible working arrangements, including remote, hybrid, field, or office schedules.

• Additional forms of incentives may be included in the overall compensation package.

• Equal opportunity employer committed to fostering diversity.