Project Manager
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Job Description
Project Manager conducting Medicaid compliance and readiness reviews for HSAG’s healthcare quality advisory services. Managing EQR work plans, audits, reports, and State Medicaid agency relationships.
Responsibilities:
- Conduct annual Medicaid compliance reviews and readiness reviews
- Contribute to annual external quality review (EQR) technical reports
- Provide day-to-day project management and support for contracted EQR activities
- Develop, coordinate, and manage project work plans and timelines
- Communicate with State Medicaid agencies, health plans, internal staff, project partners, clients, subcontractors, and other entities
- Prepare project documentation and key deliverable support documentation
- Identify opportunities to improve project processes and support quality improvement activities
- Create, distribute, and receive compliance review and readiness review tools and materials
- Prepare audit packets, including onsite/virtual document review packets
- Coordinate health plan document submissions for desk review
- Conduct onsite or virtual compliance reviews of Medicaid managed care health plans
- Assist with development, collection, analysis, and reporting of data
- Assist with developing audit reports and compiling team-member documents
- Assist with annual EQR technical reports
- Research, interpret, and apply state contract requirements, CMS rules, and state regulations
- Monitor and maintain EQRO information portals, including FTP and SharePoint sites
- Coordinate project tasks and communications
- Maintain State, health plan, and corporate communication protocols
- Coordinate and assist with EQR-related work as assigned
- Monitor and support HSAG’s compliance with State EQRO contracts
Requirements:
- Bachelor’s degree in a health-related field, or a non-healthcare related bachelor’s degree and five years of experience in Medicaid managed care compliance at a health plan or State Medicaid agency
- Medicaid and/or dual-eligible (Medicaid/Medicare) managed care experience
- Minimum five years of program evaluation/auditing experience in a health plan, state Medicaid agency, or other healthcare-related field
- Excellent oral and written communication skills
- Excellent interpersonal skills
- Organizational and time-management skills
- Experience and knowledge of quality improvement, utilization management, and/or care management practices
- Proficient in Windows environment, specifically Outlook, Word, and Excel
- Ability to work well in a remote team environment and independently
- Onsite compliance reviews require travel
- Ability to accommodate atypical work schedules due to time zone differences and occasional extended work hours
Benefits:
- Salaried full-time exempt position
- Remote work arrangement
- Reasonable accommodations for individuals with disabilities
- EEO protections for veterans, minorities, women, and individuals with disabilities
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