Project Manager, Medical Policy Processes

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

📋 Description

• Assist with team duties and project management activities as assigned.

• Oversee the daily operational elements of the Medical Policy team processes.

• Aid in the publication of Evolent Clinical Guidelines, Health Plan Specific Guidelines, and Legislative/Regulatory Guidelines.

• Maintain accurate source of truth information related to the application of clinical guidelines for utilization review requests.

• Support and uphold essential information critical for precise guideline publication.

• Generate reports and/or dashboards to illustrate project activities and their status.

• Implement project management methodologies and enforce project standards using approved toolkit templates.

⛳️ Requirements

• A Bachelor's degree along with 2+ years of project management or relevant experience in a medium to large-scale organization.

• A High School diploma or Associate’s degree with at least 5 years of project management or relevant experience within the last 8 years.

• Project Management Institute Certification (various certification options available).

• Lean Six Sigma Black Belt or Green Belt certification.

• Familiarity with project management and process improvement practices and methodologies.

• Basic understanding of health care management (CPT Codes, Medicare/Medicaid).

• Excellent facilitation and interpersonal skills, with the ability to collaborate effectively with cross-functional teams.

• Capability to address and/or escalate issues promptly.

• Proficiency in communicating difficult or sensitive information with tact.

• Demonstrated ability to plan, organize, schedule, direct, control, and monitor project activities.

• Strong working knowledge of the Microsoft Product Suite.

🏝️ Benefits

• Health insurance benefits.