项目经理II-COB，TPL，追偿
Program Manager II-COB, TPL, Subrogation
职位职责：制定计划、组织、监控并监督利用跨职能团队的项目，以实现既定需求并满足业务需求和战略目标。
- 领导跨职能的COB、TPL和追偿项目，包括供应商实施、运营改进、监管准备行动以及在多个健康计划和业务线中的追偿优化项目。
- 作为COB、TPL和追偿项目的首要协调人，通过跨运营团队组织工作，与内部利益相关者和外部供应商召开会议，跟踪交付成果，管理问题解决，并确保战略优先事项的及时执行。
- 支持促进质量、安全和护理成本机会的业务部门项目。
- 负责收集需求、制定计划和时间表、管理资源，并推动项目的执行和部署。
- 利用公司和行业标准工具和技术，根据部门流程有效监督项目。
- 维护详细的业务流程文档，包括会议纪要、行动项、问题清单和风险管理计划等。
- 创建并监控所有部门交付成果，以确保符合质量标准，包括临床报告文件、相关参考资料和政策及程序文档。
- 向管理层和关键利益相关者汇报项目状态。
- 识别资源，解决问题，并降低风险。
- 识别需求、流程和问题，以改进现有流程。
- 协调跨职能会议，与不同职能领域合作，以满足整体利益相关者期望和业务目标。
- 管理项目从开始到结束的整个生命周期。
- 提供领导力，并向所有利益相关者有效沟通项目状态。
- 与项目利益相关者协商，识别并获取资源，解决问题并降低风险。
- 完成其他指派的任务。
- 遵守所有政策和标准。
教育/经验：需要相关领域的学士学位或同等经验。要求有3年以上质量改进、项目管理或程序管理经验。医疗保健经验优先。
优选：具有COB、TPL、追偿、追偿运营、支付准确性或索赔运营方面的医疗保健经验。优选具备领导跨职能团队的经验。
查看英文原文
Position Purpose: Plan, organizes, monitor, and oversee programs utilizing cross functional teams to deliver defined requirements and meet business needs and strategic objectives.
- Lead cross-functional COB, TPL, and Subrogation initiatives including vendor implementations, operational enhancements, regulatory readiness efforts, and recovery optimization projects across multiple health plans and lines of business.•
- Serve as the primary coordinator for COB, TPL, and Subrogation initiatives by organizing work across operational teams, facilitating meetings with internal stakeholders and external vendors, tracking deliverables, managing issue resolution, and ensuring timely execution of strategic priorities.
- Support business department initiatives that promote, quality, safety and cost of care opportunity.
- Responsible for gathering requirements, creating plans and schedules, managing resources, and facilitate project execution and deployment.
- Utilize corporate and industry standard tools and techniques to effectively oversee programs according to department procedures.
- Maintain detailed business process documentation including meeting minutes, action items, issues lists and risk management plans as applicable.
- Create and monitor all department deliverables to ensure adherence to quality standards including clinical reporting documents, related reference materials, and policy and procedure documentation.
- Communicate program status to management and key stakeholders.
- Identify resources, resolve issues, and mitigate risks.
- Identify requirements, procedures and problems to improve existing processes.
- Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and business objectives.
- Manage projects through the full project life cycle.
- Provide leadership and effectively communicate project status to all stakeholders.
- Negotiate with project stakeholders to identify and secure resources, resolve issues and mitigate risks.
- Performs other duties as assigned.
- Complies with all policies and standards.
Education/Experience: Bachelor's Degree in related field or equivalent experience required. 3+ years of quality improvement, program management or project management experience required. Health care experience preferred.
Preferred: Healthcare experience with COB, TPL, Subrogation, Recovery Operations, Payment Integrity, or Claims Operations. Preferred experience leading cross-functional initiatives involving vendors, technology teams, and business stakeholders. Preferred knowledge of Medicare, Medicaid, and Commercial healthcare reimbursement and recovery processes.
Pay Range: $70,100.00 - $126,200.00 per year
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Originally posted on Himalayas