The RN-Project Manager is responsible for all aspects of business development, project management, and program implementation and prescribed activities are carried out in accordance with specified objectives as relative to the Mississippi Medicaid contract held by Alliant, including oversight for all aspects of day-to-day contract operations and subcontractors as well as the initiation of strategic planning, project management, and quality improvement activities intended to enhance the service quality.. The Project Manager plans and develops methods and procedures for implementing the program, directs and coordinates program activities, and exercises control over personnel responsible for specific functions or phases of program.
ESSENTIAL JOB FUNCTIONS
Serve as primary liaison to the state program leadership, provider community and key stakeholder groups on all aspects of the UM/QI contract and related activities.
Provide oversight for all aspects of day-to-day contract operations and subcontractors, as well as the initiation of strategic planning and quality improvement activities intended to enhance service quality and contract performance.
Manage contract budgets, subcontractors, and consultant agreements within established fiscal parameters as determined by Alliant senior leadership.
Plan and implement program changes, as prescribed by contractors and state agencies, related to web-enabled applications, review criteria and procedures, and state policy/regulations.
Establish policies and procedures related to the department to ensure the timely and successful completion of all contract deliverables.
Review reports and records of activities to ensure progress is being made toward specific program objective and modifies or changes methodology as needed to redirect activities and attain objectives.
OTHER IMPORTANT JOB FUNCTIONS
Select personnel according to knowledge and experience in area with which program is concerned.
Coordinates all written and oral communications intended to inform and education providers, their representatives, and other stakeholders.
Maintain review information and record confidentiality in accordance with Alliant policy as well as state and federal regulations.
Manage personnel issues and intervene to facilitate the resolution of problems/issues related to the departmental team or their work.
Assess new business opportunities for organization and develop proposals as assigned by COO.
Maintains security and confidentiality of all information in accordance with HIPAA laws and regulations and Alliant policies.
KNOWLEDGE, SKILLS, AND ABILITIES
Proficient in project management of multi-million dollar contract. Ability to direct a professional, multi-disciplinary work team in the development, implementation, operation and evaluation of contracted programs.
Demonstrate working knowledge of complaint management, service recovery, change management and risk management processes.
Excellent written, verbal, and presentation skills required.
Group facilitation and consensus building skills required.
Knowledge of Medicaid programs is required.
Knowledge and skill in prioritizing, scheduling, coordinating work while managing multiple tasks and deadlines
Intermediate-level knowledge of Microsoft Office Products.
Ability to travel by car or airplane to customer and Company meetings as needed.
EDUCATION, EXPERIENCE, AND TRAINING
Bachelor’s degree or equivalent work experience with Master’s degree in public health, public administration, hospital administration, nursing, or business administration with
Seven (7) or more years of current medical utilization review management experience with supervisory experience preferred
Seven (7) or more years of current experience managing and/or working with Medicaid, government health plans, or authorization programs is required
Experienced in project management or quality improvement tools and techniques.
This opportunity is based in Jackson, MS and offers work/life balance and great benefits.
Alliant Health Solutions is an Equal Employment Opportunity Employer (EOE) and Drug Free Workplace. In compliance with the ADA Amendments Act (ADAAA), all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, please let us know. Likewise, if you are limited in the ability to access or use this online application process and need an alternative method for applying, we will determine an alternative method for you to apply. Please contact HR@allianthealthsolutions.com or 678-527-3000. EOE/Disability/Vet
Internal Number: 39157
About Alliant Health Solutions
Alliant Health Solutions is a family of companies that provides professional services supporting the effective administration of health care programs and funding to support health care improvement initiatives. Alliant’s experience spans the full spectrum of care settings and provider types, including acute care, advanced imaging, behavioral health, dental, dialysis, home health, hospice, long-term care, physician practices, skilled nursing, hospitals and more.
Alliant has three primary lines of service offerings that leverage evidenced-based methods, data and technology, and clinical expertise:
Healthcare Quality Improvement: making health care safer and more effective.
Utilization Management: ensuring the right care, in the right setting for the right duration.
Program Integrity: ensuring compliance and reducing improper payment, fraud, waste and abuse.
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