[Hiring] Risk Adjustment Project Manager I/II/III @company

Role Description

Under the guidance of Risk Adjustment leadership, this position is responsible for delivering multiple concurrent Risk Adjustment Projects and Programs with quality, to plan, and within budget. The Risk Adjustment Project Manager is responsible for all aspects of the project from initiation to post-implementation monitoring and maintenance. This will include developing communications and presenting to internal and external audiences.

• Manages risk adjustment projects as assigned.
• Govern and provide oversight of assigned vendor partners within the Risk Adjustment Program Portfolio.
• Conducts operational process analysis and process improvement identification and recommendations.
• Responsible to fill one or more roles on Maintenance of Business (MOB) project teams.

Essential Primary Responsibilities/Accountabilities:

• Plans, directs, and coordinates matrixed team(s) activities to manage and implement interrelated risk adjustment projects.
• Plans, schedules, monitors, and reports on activities related to Risk Adjustment projects and process improvement initiatives.
• Guides and mentors Implementation project management team.
• Creates the Risk Adjustment project work plans and is responsible for their execution.
• Acts independently to assess and monitor projects and vendor partners performance.
• Trains and mentors project team on project work and tools.
• Writes and speaks fluently on all aspects of work.
• Organizes and prioritizes tasks and proposed work assignments.
• Manages multiple projects with competing deadlines.
• Acts as Project Manager, Product Manager, Program Manager, Test Lead, and User Experience Lead as needed.
• Responsible for the creation and deployment of monitoring reports of the assigned Risk Adjustment projects.
• Enhances communication within and outside key Risk Adjustment priorities.
• Meets with management, sponsors, and project teams to review project scope/progress.
• Coaches and counsels members of cross-functional teams.
• Establishes appropriate metrics for measuring key project criteria.
• Selects and applies appropriate tools for project planning.
• Produces work plans according to required standards.
• Works with colleagues to produce/recommend/develop long-term plans.
• Fosters a positive environment of continuous process improvement.
• Monitors and reports on the progress of the resolution of high impact problems.
• Ensures contracted vendor partners are managed using standard governance processes.
• Executes and manages vendor performance corrective action plan.
• Conducts post project Lessons Learned sessions.
• Acts professionally and encourages professional standards among staff.
• Maintains high regard for member privacy.
• Regular and reliable attendance is expected and required.
• Performs other functions as assigned by management.

Level II - performs these additional responsibilities:

• Acts as lead and contact company-wide for Risk Adjustment projects.
• Represents Managers and Directors of supported areas in all related projects.
• Determines, monitors, and reviews all project economics.
• Formulates contingency plans to address schedule revisions and work requirements.

Level III - performs these additional responsibilities:

• Responsible for ensuring validated payment to contracted vendor partners.
• Develops vendor performance metrics to monitor and evaluate vendor performance.
• Leads in the identification and selection of vendors.
• Develops risk adjustment vendor contracts.
• Leads re-negotiation and/or termination activities related to vendor relationships.

Qualifications

• A relevant BS degree and a minimum of 2 years of Project Management experience.
• A minimum of 3 years demonstrated performance in a related area.
• PMP/PMI Certification preferred.
• Lean Six Sigma experience desired.
• Expert knowledge of Health Plan Operations and/or Risk Adjustment Operations.
• Demonstrated leadership skills.
• Demonstrated skills in developing and achieving project scope, costs, planning, and meeting project deliverables.
• Demonstrated skills in forming and fostering high performance, cross-functional teams.
• Highly Effective communicator.
• Demonstrated skills in quality principles, especially root cause analysis and problem solving.
• Very strong analytical and business process development skills.
• Strong organizational and multi-tasking skills.
• Demonstrated competence in staff leadership and project leadership tasks.

Requirements

• Level II: A relevant BS degree and a minimum of 3 years Project Manager experience.
• Level III: A relevant BS degree and a minimum of 5 years Project Management experience.
• PMP/PMI Certification required for Level II and Level III.

Physical Requirements

• Ability to travel across regions.

Compensation Range(s)

• Level I: Grade E3: Minimum $62,400 - Maximum $106,929.
• Level II: Grade E4: Minimum $65,346 - Maximum $117,622.
• Level III: Grade E5: Minimum $71,880 - Maximum $129,384.

The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, in addition to internal equity.

Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.