Project Manager- Consultant I

Role Description

We are looking for a strategic and customer-focused Manager to join our team. You will be responsible for guiding the success of a function and leading the cross-functional team that is responsible for improving it. This is a key role that requires strong collaboration, market research, data-driven decision-making, and a deep understanding of business operations and functional area.

• Ability to collaborate effectively with stakeholders at all levels, including business users, technical teams, and executives.
• Commitment to continuous learning and staying up to date on industry best practices.
• Own functional area and is consulted for implementations and operations.
• Gather and prioritize functional requirements from stakeholders, customers, and market trends.
• Work closely with internal project teams, technical and business operations, customer success and vendor management teams to deliver quality service and support on time.
• Liaison between partner and HE teams and standardize implementation and operations across customer.
• Own and manage governance model with functional partners.
• Analyze user feedback and identify opportunities for product enhancements.
• Act as the voice of the customer in all partner discussions.
• Support continuous improvement by analyzing project outcomes and lessons learned.
• Attention to detail and a strong sense of accountability.
• Overtime or weekend work may be required during critical project phases.
• Work with global teams and support global time zones as needed.
• Ability to wear multiple hats, and flexibility to adapt with changing customer needs.
• Work closely with internal teams to streamline workflows and implement best practices for Mailroom and EDI optimization.
• Ensure that service-level agreements (SLAs) are met.

Qualifications

• Bachelor’s degree in Healthcare Administration, Information Systems, Business, or a related field.
• 5+ years of experience in healthcare EDI transactions, client management, or payer operations.
• Experience in healthcare claims processing, eligibility verification, and remittance advice transactions.

Requirements

• Strong understanding of EDI transaction sets (837, 835, 270/271, etc.).
• Strong understanding of Mail Room Operations.
• Strong knowledge of CMS, Medicaid, Medicare, and commercial payor regulations.
• Proven ability to manage client expectations, drive issue resolution, and lead cross-functional coordination.
• Excellent communication, negotiation, and stakeholder management skills.
• Familiarity with tools such as Jira, Smartsheet, Confluence, or similar.

Benefits

• Remote, US.
• Full-time, permanent.
• Exempt (FLSA Classification, USA Only).

Work Environment

• The employee is occasionally required to move around the office.
• Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
• Work across multiple time zones in a hybrid or remote work environment.
• Long periods of time sitting and/or standing in front of a computer using video technology.
• May require travel dependent on company needs.