• Healthcare experience from a Payer’s perspective (this is a must-have)
• Care Management (CM) – healthcare payer perspective
• Disease Management (DM) – healthcare payer perspective
• Utilization Management (UM) – healthcare payer perspective
• ICD 9/10 experience is helpful
• CMS (Centers for Medicare & Medicaid Services)
• Experience with end to end processing
• Big 4 or Consulting background will put you to the top of the list
SKILLS:
• Must have 7-10+ years of experience managing projects in the health insurance industry, preferably in the Quality or Care Management area.
• Healthcare Insurance domain background is a must-have
• Project Methodologies experience – Agile, Waterfall, or Hybrid is all okay.
• MS Project, SharePoint, Excel, Visio, PowerPoint.
• Bachelor’s degree or equivalent work experience – Education is helpful, not necessary
• PMP Certification – beneficial but not a must-have
All your information will be kept confidential according to EEO guidelines.
Job details are sourced from the employer's original posting.
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