Job Description

Project Manager - Healthcare Payer Group Portal Implementations

We are seeking a highly organized and experienced Project Manager to oversee the end-to-end implementation of SaaS-based digital portal solutions within the health insurance industry (Payer side). This role requires a professional with a deep understanding of healthcare operations (specifically the payer environment, not the provider side) and a proven track record of managing complex software implementations to drive enhanced customer service and improve the Group Portal experience for our clients. The ideal candidate will combine strong project management skills with a client-facing mindset to ensure seamless onboarding and successful adoption of our technology solutions.

Definition of Key Terms in this Role:

• Payer Portal: A secure, online platform provided by health insurance companies (payers) that allows members to access benefit information, view claims status, find providers, and make premium payments.
• Group Portal: A specific type of payer portal designed for employers or benefit administrators. It allows group administrators to manage employee enrollment, update coverage details, view billing statements, and perform other administrative tasks on behalf of their covered group.

Key Responsibilities:

• Lead the planning, execution, and final delivery of healthcare portal implementations for health plan payer clients, ensuring projects are delivered on time and within budget.
• Serve as the primary point of contact for clients, managing expectations, facilitating communication, and ensuring high-quality customer service throughout the implementation lifecycle.
• Conduct discovery sessions and workflow mapping to ensure alignment between client requirements and system capabilities, specifically regarding Group Portal administration features.
• Develop comprehensive project plans, track progress, manage scope changes, and maintain detailed, audit-ready documentation.
• Identify potential project risks related to data security, privacy, and system integration, developing and implementing effective mitigation strategies.
• Coordinate cross-functional teams, including IT professionals, administrators, and third-party vendors, fostering a collaborative and productive environment.
• Provide training and support to client group administrator and end-users to ensure smooth transitions and high user adoption of new systems.
• Ensure all projects strictly adhere to relevant healthcare regulations and compliance standards, including HIPAA and HITECH requirements.

Required Skills & Experience:

• Proven experience in project management within the healthcare industry, with direct experience in payer organizations (health insurance plans).
• Demonstrated success in leading customer-facing software implementation projects, particularly those involving digital portal technologies or similar member/group interfaces.
• Familiarity with group administration and enrollment processes within a health insurance context is highly desirable.
• Strong understanding of project management methodologies (Agile, Scrum, Waterfall) and experience with relevant project management tools (e.g., JIRA, MS Project).
• Excellent leadership, communication, and interpersonal skills, with the ability to manage diverse stakeholders and drive consensus.
• Strong analytical and problem-solving abilities, with an aptitude for data-driven decision-making.
• Bachelor's degree in a relevant field; PMP certification or equivalent is preferred.
• Proficiency with large data management concepts and healthcare interoperability standards (HL7, FHIR) is a bonus.

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