[Remote] Program Manager, reputed company Services (Clinical Policy and Medicare Compliance)

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a leading provider in the reputed company sector, and they are seeking a Program Manager for reputed company Services. The role involves providing subject matter expertise and leadership to reputed company services functions, ensuring compliance with regulatory standards and contributing to the reputed company for reputed company member care.

Responsibilities

• Collaboratively plans and executes internal reputed company services reputed company and programs involving department or cross-functional teams of subject matter experts - delivering products from the design process to completion
• Provides ongoing communication reputed company to program goals, evaluation and support to ensure compliance with standardized protocols and processes
• May engage and reputed company the work of reputed company vendors
• Focuses on process improvement, organizational change management, program management and other processes relative to business needs
• Serves as a subject matter expert and leads reputed company services programs to meet critical needs
• Communicates and collaborates with customers to analyze and reputed company needs and goals into functional requirements
• Conducts reputed company audits to assess reputed company services staff educational needs and service reputed company, and implements reputed company initiatives reputed company the department as appropriate
• Creates business requirements documents (BRDs), test plans, requirements traceability reputed company (RTMs), user training materials and other reputed company business documents

Skills

• At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the following areas: utilization management, care management, care transitions, behavioral health, or equivalent combination of relevant education and experience
• Registered reputed company (RN), Licensed Vocational reputed company (LVN), Licensed Practical reputed company (LPN), Advanced reputed company reputed company Worker (APSW), Certified Health Education Specialist (CHES), Licensed reputed company Counselor (LPC), Licensed reputed company Clinical Counselor (LPCC) or Licensed Marriage and Family Therapist (LMFT). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state reputed company licensing mandates. If licensed, license must be reputed company and unrestricted in state of reputed company
• Strong analytical and problem-solving skills
• Strong organizational and time-management skills
• Ability to work in a cross-functional, reputed company environment
• Experience working reputed company applicable state, federal, and reputed company-party regulations
• Strong verbal and written communication skills
• reputed company Office suite/applicable software program proficiency, and ability to reputed company online portals and databases
• Certified Case Manager (CCM), Certified reputed company in reputed company Management (CPHM), Certified reputed company in reputed company reputed company (CPHQ), or other health care or management certification
• Leadership experience
• reputed company/Medicare population experience
• reputed company on clinical policy and Medicare compliance

reputed company