RMRA Project Manager - Health Alliance Plan - Troy

📁
Business (Non-Clinical)
📅
202973 Requisition #
GENERAL SUMMARY: 

Identifies Revenue Management and Risk Adjustment (RMRA) department program needs and requirements.  Responsible for leading the design, development, testing and roll out of new RMRA programs and existing program improvements. 
 
PRINCIPLE DUTIES AND RESPONSIBILITIES: 

Plan and organize the program: In partnership with the RMRA Manager(s), leads development of prospective, retrospective and coding/auditing risk adjustment programs.  In addition, leads development of data management and revenue management programs.   
  • Define and negotiate Project Scope and Deliverables 
  • Identify costs and benefits of the project 
  • Obtain approval for projects, justifying the return on investment. 
  • Plan and staff projects. 
  • Plan and schedule user training related to the project’s implementation. 
  • Document and communicate process models, project scope, deliverables and commitments. 
  • Manage and operationalize the program: 
    • Produce project status reports, work plans, time lines, budget reports, risk management, issue lists, and project metrics. 
    • Monitor progress, change control, issue resolution. 
    • Manage scope change, issue resolution, and negotiate change in deliverables. 
    • Ensure appropriate documentation for user manuals, training materials. 
    • Provide feedback to line manager on team member performance. 
    • Manage post implementation support. 
    • Provide post implementation project review. 
  • Additional duties:  
    • Assist with overall IT Strategic Planning 
    • Assist in determining annual planning according to resource and budget allocation. 
    • Evaluation of existing programs to improve operations to gain premium increase/quality improvement, efficiencies and enhanced clinical coding and documentation. 
    • Research, collect and analyze claims, clinical, HCC, encounter & RAPS data and best practices in managed care in order to assist in making operational decisions. 
    • Provide extensive communication to all levels of management and staff to encourage participation and support related to a project.  Assure the communication is timely and well-articulated. 
    • Communicate with internal and external customers to gather supporting information and/or educate regarding policy and procedural changes. 
    • Prepare and present projects and provide status reports to immediate and next level management. 
    • Participation on assigned committees, teams and projects 
    • Provide department-wide education, training and create training documents and manuals. 
    • Conduct department audits to ensure regulatory compliance and perform quality reviews and assessments 
    • Support the department management to prepare in-depth reporting, pre-planning and taking a pro-active approach to project management.   
    • Work independently or in teams as required. 
    • Perform all other responsibilities as assigned. 
EDUCATION/EXPERIENCE REQUIRED: 
  • Bachelor’s Degree in Business Administration, Project Management or Computer Science with training in personal computing, networking, mainframe and client server applications. 
  • Three (3) years of project management experience in running large projects of a complex nature. 
  • One (1) year of information systems experience in computer related areas mainframe, network, internet, intranet and client server application development, including new product implementation. 
  • Two (2) years of experience at all levels of system development projects with emphasis in leading large, multi-disciplinary teams evaluating and implementing technologies. 
  • Two (2) years of managed care/insurance related business preferred. 
  • One (1) year of experience in supervisory/management position preferred. 
  • One (1) year of experience in development of process and project methodologies preferred. 
  • Additional experience in Project Management, Risk Management, Customer Service, Project/Resource Planning, Metrics Reporting, Systems Design, Application Development and Client Server Implementation preferred. 
CERTIFICATIONS/LICENSURES REQUIRED: 
  • Current Project Management Institute Certification or must obtain within three (3) years of hire date

    Overview

       Under the leadership of President and CEO Wright L. Lassiter, III, Henry Ford Health System is a

       $6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sites

       including medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities and

       other healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health system

       now has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, one

       of the nation’s oldest physician groups. An additional 2,200 physicians are also affiliated with the

       health system through the Henry Ford Physician Network. Henry Ford is also one of the region’s  

       major academic medical centers, receiving between $90-$100 million in annual research funding and

       remaining Michigan’s fourth largest NIH-funded institution. Also an active participant in medical

       education and training, the health system has trained nearly 40% of physicians currently practicing

       in the state and also provides education and training for other health professionals including nurses,

       pharmacists, radiology and respiratory technicians. visit HenryFord.com.

     Benefits

       Whether it's offering a new medical option, helping you make healthier lifestyle choices or

       making the employee enrollment selection experience easier, it's all about choice.  Henry

       Ford Health System has a new approach for its employee benefits program - My Choice

       Rewards.  My Choice Rewards is a program as diverse as the people it serves.  There are

       dozens of options for all of our employees including compensation, benefits, work/life balance

       and learning - options that enhance your career and add value to your personal life.  As an

       employee you are provided access to Retirement Programs, an Employee Assistance Program

       (Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness,                 and a whole host of other benefits and services.  Employee's classified as contingent status are not         eligible for benefits.    

      Equal Employment Opportunity/Affirmative Action Employer

        Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is

        committed to the hiring, advancement and fair treatment of all individuals without regard to

        race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,

        weight, marital status, family status, gender identity, sexual orientation, and genetic information,

        or any other protected status in accordance with applicable federal and state laws.

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