Business Project Mgmt Specialist

  • Negotiable
  • Jacksonville, FL, États-Unis
  • CDI, Plein-temps
  • Florida Blue
  • 05 déc. 17 2017-12-05

* Responsible for vendor monitoring and oversight to ensure compliance with contractual terms and effectiveness of operational processes. * Responsible for program design documentation and reporting of vendor performance (operational, compliance, contractual). * Responsible for integrating with the vendor and operational areas to support new and improved processes. * Support evaluation and analysis of vendor financial and operational performance. .

Major Responsibilities:

  • Responsible for vendor monitoring and oversight to ensure compliance with contractual terms and effectiveness of operational processes.
  • Responsible for program design documentation and reporting of vendor performance (operational, compliance, contractual).
  • Responsible for integrating with the vendor and operational areas to support new and improved processes.
  • Support evaluation and analysis of vendor financial and operational performance.
  • Coordinate with all levels of management and departments internal and external to the Payment Integrity Office (PIO).
  • Provide vendor education to internal areas.
  • Coordinate regular meetings to facilitate a venue for sharing and monitoring operational performance, service level agreements, and process improvement opportunities.
  • Ensure vendor completion of corporate compliance requirements, training and annual due diligence requirements.

Minimum Job Requirements:

  • Bachelor's degree in relevant area or equivalent work experience
  • 5+ years experience with one or more of the following: implementing and/or monitoring projects, programs, and/or vendors, leadership experience in an operational area, leading/implementing continuous improvement efforts, experience acting as a subject matter expert (SME) in the design of processes and/or business requirements for new products, programs or services.
  • 2+ years' experience implementing and/or monitoring projects, programs, and/or vendors.
  • Working knowledge of various components of the business (i.e. Delivery System, Service, Network, Product, etc.)
  • Demonstrated integration and project management skills.
  • Experience developing and presenting documentation, decision memos, and presentations for leadership
  • Experience utilizing continuous improvement tools/techniques
  • Ability to build and maintain strong business relationships
  • Strong written and verbal communication skills
  • Strong leadership skills

Preferred:

  • Experience supporting Service and/or Delivery System programs, projects, and initiatives.
  • Knowledge of and/or experience working in payment integrity
  • Prior experience with vendor implementation and/or vendor management.
  • Knowledge of claims processing and inpatient reimbursement methodologies.