Project Manager - Medicare Advantage Admin at Johns Hopkins Health Care in Hanover, Maryland

Job Description:

PROJECT MANAGER - MEDICARE ADVANTAGE ADMIN

Requisition #: 307545
Location: Johns Hopkins Health Care, Hanover, MD 21076
Category: Non-Clinical Professional
Work Week: Full Time (40 hours)
Weekend Work Required: No
Date Posted: Nov. 23, 2020

Johns Hopkins HealthCare (JHHC) is the managed care and health services business of Johns Hopkins Medicine, one of the premier health delivery, academic, and research institutions in the United States. JHHC is a $2.5B business serving over 400,000 lives with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHC has become a leader in provider-sponsored health plans and is poised for future growth.

Many organizations talk about transforming the future of healthcare, Johns Hopkins HealthCare is actually doing it. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for the members and communities we serve. If you are interested in improving how healthcare is delivered, join the JHHC team.

Must be familiar with all administrative aspects of operations. The Project Manager will be responsible for project management and identification, development and implementation, including providing staff support in planning and managing departmental and organizational initiatives and administrative projects. Facilitates information exchange between JHHC senior management and departments, Johns Hopkins Medicine (JHM) entities, vendors/consultants and outside agencies.

Responsible for planning and managing departmental and organizational initiatives and administrative projects in relation to the Medicare Advantage line of business. Responsible for facilitating information exchange between JHHC senior management, internal and external entities, vendors/consultants, and outside agencies. Position is also responsible for contracting, management and coordination of the plan s contracted Medicare Advantage vendor relationships. Responsible for management and evaluation of all contracted vendors in regards to utilization targets as well as contractual service standards for Medicare Advantage. Responsibilities include planning, coordinating, and evaluating the implementation of strategic plans that will ensure adequate network access with the contracted Medicare Advantage vendors, along with fee schedule analysis, contract surveillance and development of new contracting opportunities. This position continually evaluates and recommends direction regarding the Medicare Advantage vendor program. Responsible for developing and maintaining departmental Medicare Advantage policies, procedures, and workflows. Oversight for Medicare Advantage, in relation to the Provider Relations Department, including responsibility of auditing departmental staff to ensure compliance with regulatory standards, recommends improvements within various organizational initiatives both internally with data gathering and interpretation and externally with report distribution and education of the provider network. Assists in the training and education of newly hired provider relations staff, as it relates to Medicare Advantage.

Requirements:

* Education:

A Bachelor s Degree in Business, Health Administration or Educational Training is required; A Master s Degree is preferred. Some equivalent Project Management experience may substitute for educational requirements on a 2:1 basis.

B. Knowledge:

Knowledge of project management, financial analysis, and business/strategic planning is required. Knowledge of Quality Management, Planning and Administrative theory, and Customer Service Theory is preferred. Knowledge and experience related to project management and implementation of strategic initiatives.

C. Skills:

High level of interpersonal skill, written and oral communication necessary to interface with various levels of management. Ability to work independently and meet scheduled time frames; manage multiple projects simultaneously; and prepare oral and/or written presentations to senior management. Ability to compile and coordinate high quality reports, proposals and written work product for customers. Must have high level of spreadsheet, database, presentation, and project scheduling and word processing software skills. High level of meeting management, computer, teaching and training, organization and time management, High level of leadership/facilitation skills. High level of analytical ability necessary to identify and illustrate relationships among activities, recommend courses of action based on making choices among alternative and design recommended.

D. Required Licensure, Certification, Etc.:

None.

E. Work Experience:

Minimum of 3 years of experience in Business, program development and/or project development/management preferably in health insurance is required. Experience in managing projects in Functional Environment is a plus.

F. Machines, Tools, Equipment:

Computer, electronic mail, telephone systems, general office and communication equipment

Dimensions:

A. Budget Responsibility:

Fiscal awareness makes appropriate recommendations r/t equipment, supplies, etc. Effectively utilize resources within control and budget. Tracks budget associated with projects.

B. Authority/Decision Making Level:

Manage work independently. Arranges daily schedule to meet customer and project needs. Works within JHM decision-making hierarchy. Escalates within the organization as needed.

C. Supervisory Responsibility:

May delegate to others on project team

Problem Solving:

Ability to assess, plan and implement projects. Awareness of need for timely communication, able to identify potential barriers and strategies, and able to synthesize and integrate information. Able to offer unique solutions, and fresh approach to inspire team members to pursue non-traditional methods when appropriate.

Information Management:

Able to read and interpret variety of reports. Ability to input, manage and extract reports and other information. Knowledge of Microsoft Sharepoint for documentation and project planning purposes is beneficial.

Working Conditions:

Works in a normal office environment where there are no physical discomforts due to temperature, noise, dust, etc. Work is sedentary in nature and requires frequent computer usage

Johns Hopkins Health System and its affiliates are Equal Opportunity/Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity, sex, age, national origin, disability, protected veteran status, and or any other status protected by federal, state, or local law.

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