• Healthcare experience from a Payer’s perspective (this is a must-have)

• Care Management (CM) – healthcare payer perspective

• Disease Management (DM) – healthcare payer perspective

• Utilization Management (UM) – healthcare payer perspective

• ICD 9/10 experience is helpful

• CMS (Centers for Medicare & Medicaid Services)

• Experience with end to end processing

• Big 4 or Consulting background will put you to the top of the list

SKILLS:

• Must have 7-10+ years of experience managing projects in the health insurance industry, preferably in the Quality or Care Management area.

• Healthcare Insurance domain background is a must-have

• Project Methodologies experience – Agile, Waterfall, or Hybrid is all okay.

• MS Project, SharePoint, Excel, Visio, PowerPoint.

• Bachelor’s degree or equivalent work experience – Education is helpful, not necessary

• PMP Certification – beneficial but not a must-have

All your information will be kept confidential according to EEO guidelines.