Senior Project Manager (Medicaid Network Implementation) - Remote US

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 Humana Healthy Horizons is a seeking a Senior Project Manager (Medicaid Network Implementation) who is accountable for working with the Director, Network Implementations, Provider Strategy & Operations, to assist with driving efficient management of end-to-end provider-related functions in new Medicaid market implementations. The Senior Project Manager makes decisions supporting technical and operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves processes and performance.

The Senior Project Manager (Medicaid Network Implementation) translates network and provider strategies into tactical plans that can be executed on to ensure timely and successful new market launches and requires an in-depth understanding of how organization capabilities interrelate across the function or segment. The Senior Project Manager directs the timelines, processes, and enterprise readiness to effectively implement network development strategies.

Key Responsibilities:

• Oversee the provider pillar within Medicaid market implementations to ensure timely and accurate delivery of the network build and coordinate with health plan operational functions. This includes network contracting, provider operations, value-based payment, and provider services areas.
• Partner with cross functional and matrixed teams to drive key operational decisions, oversee implementation progress and milestones, and other project management functions.
• Develop and maintain project plan.
• Manage the RAID log (Risk/Issues log for escalations).
• Convene matrixed operational partners to solve for operational gaps/barriers. Solutioning may also include some product development responsibilities, such as developing timelines, process maps, and process flow diagrams in partnership with subject matter experts.
• Lead provider and network implementation preparation, including identifying business owners and subject matter experts in contract shreds, identifying potential business or operational gaps and state nuances.
• Participate in state meetings and share …