Match score not available

Senior Program Manager-Claims

Remote:

Full Remote

Contract:

Fixed term

Salary:

192 - 211K yearly

Experience:

Senior (5-10 years)

Work from:

Minnesota (USA), United States

Offer summary

Qualifications:

5+ years in health insurance program management, Experience in claims processing and product development, PMP, PgMP, or relevant healthcare certifications preferred, Strong knowledge of regulatory requirements and methodologies.

Key responsabilities:

Develop and execute program strategies
Manage multiple projects across stakeholders

Genesis10 Large https://www.genesis10.com/

1001 - 5000 Employees

See all jobs

Job description

Genesis10 is seeking a Senior Program Manager – Health Insurance/Claims experience for a 12 month contract with our client in Minnetonka, MN. 100% Remote.

Job Summary:

We are seeking a Program Manager with experience in health insurance plans to oversee and drive strategic initiatives across multiple projects. This role will be responsible for aligning programs with business objectives, managing cross-functional teams, and ensuring the successful execution of initiatives related to The ideal candidate has a strong background in claims and the lifecycle of claims processing combined with excellent leadership and project management skills.

Key Responsibilities:

Program Strategy & Execution: Develop and execute program strategies aligned with the company's goals in health insurance plan development and administration.
Project Oversight: Manage multiple projects related to product development, provider networks, regulatory compliance, and customer experience improvements.
Stakeholder Collaboration: Work closely with actuarial, underwriting, claims, network management, IT, and regulatory teams to ensure seamless execution.
Regulatory Compliance: Ensure programs align with state and federal healthcare regulations (e.g., ACA, CMS, Medicare, Medicaid).
Process Improvement: Identify and implement best practices for operational efficiency and member experience enhancements.
Budget & Resource Management: Manage program budgets and optimize resource allocation.
Risk & Issue Management: Identify potential risks, develop mitigation strategies, and proactively resolve issues.
Reporting & Metrics: Provide regular status updates to senior leadership on program performance, risks, and key deliverables.
Vendor & Provider Relations: Manage relationships with external vendors, healthcare providers, and third-party administrators.

Required Basic Qualifications:

Experience: 5+ years of experience in program or project management within the health insurance specific to claims.
Certifications (Preferred): PMP, PgMP, Six Sigma, or relevant healthcare certifications (e.g., AHM, CPCU).
Skills:
- Strong knowledge of health insurance products, claims processing, provider contracting, and regulatory requirements.
- Experience managing projects within Medicare, Medicaid, ACA, or employer-sponsored health plans.
- Proficiency in Agile, Scrum, and Waterfall methodologies.
- Familiarity with healthcare IT systems
- This role will be 60% on the business side and 40% technology
- Excellent leadership, communication, and stakeholder management skills.

Preferred Qualifications:

Experience working with health insurance payers, providers, or regulatory agencies.
Experience working on a claims migration program before

Compensation: Hourly W2 pay rate $100-110

Only candidates available and ready to work directly as Genesis10 employees will be considered for this position.

If you have the described qualifications and are interested in this exciting opportunity, apply today!

Ranked a Top Staffing Firm in the U.S. by Staffing Industry Analysts for six consecutive years, Genesis10 puts thousands of consultants and employees to work across the United States every year in contract, contract-for-hire, and permanent placement roles. With more than 300 active clients, Genesis10 provides access to many of the Fortune 100 firms and a variety of mid-market organizations across the full spectrum of industry verticals.

For contract roles, Genesis10 offers the benefits listed below. If this is a perm-placement opportunity, our recruiter can talk you through the unique benefits offered for that particular client. Benefits of Working with Genesis10:

• Access to hundreds of clients, most who have been working with Genesis10 for 5-20+ years.
• The opportunity to have a career-home in Genesis10; many of our consultants have been working exclusively with Genesis10 for years.
• Access to an experienced, caring recruiting team (more than 7 years of experience, on average.)
• Behavioral Health Platform
• Medical, Dental, Vision
• Health Savings Account
• Voluntary Hospital Indemnity (Critical Illness & Accident)
• Voluntary Term Life Insurance
• 401K
• Sick Pay (for applicable states/municipalities)
• Commuter Benefits (Dallas, NYC, SF)

For multiple years running, Genesis10 has been recognized as a Top Staffing Firm in the U.S., as a Best Company for Work-Life Balance, as a Best Company for Career Growth, for Diversity, and for Leadership, amongst others. To learn more and to view all our available career opportunities, please visit us at our website.
Genesis10 is an Equal Opportunity Employer. Candidates will receive consideration without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

#LI-TJ1