Program Manager - Health Insurance

Genesis10
100.00 110.00 Hour
life insurance, 401(k)
United States, Minnesota, Minnetonka
Jan 30, 2025
Genesis10 is seeking a Health Insurance Program Manager for a remote 12-month contract with our client. Job Summary: Genesis10 is seeking an experienced Program Manager to lead strategic initiatives in health insurance plan management. The ideal candidate will drive cross-functional projects, combining deep healthcare industry expertise with strong project management skills. This remote role requires a strategic thinker who can balance business objectives with technological implementation, with responsibilities split 60% business-focused and 40% technology-oriented. Key Responsibilities: Strategic Program Development: Craft and execute comprehensive strategies for health insurance plan development and administration, ensuring alignment with organizational goals and industry best practices. Complex Project Management: Oversee multiple concurrent projects spanning product development, provider network management, regulatory compliance, and customer experience improvement initiatives. Cross-Functional Leadership: Collaborate effectively with diverse teams including actuarial, underwriting, claims, network management, IT, and regulatory departments to ensure seamless program execution. Regulatory Compliance Management: Maintain rigorous adherence to state and federal healthcare regulations, including ACA, CMS, Medicare, and Medicaid requirements. Operational Excellence: Drive continuous process improvements to enhance operational efficiency, optimize member experiences, and streamline administrative workflows. Financial and Resource Optimization: Manage program budgets strategically, allocate resources efficiently, and demonstrate fiscal responsibility. Risk and Issue Management: Proactively identify potential risks, develop robust mitigation strategies, and resolve complex challenges before they escalate. Executive Reporting: Prepare comprehensive status reports for senior leadership, highlighting program performance metrics, potential risks, and key deliverable achievements. External Relationship Management: Develop and maintain strategic relationships with external vendors, healthcare providers, and third-party administrators. Required Qualifications: Minimum 5+ years of program/project management experience specifically in health insurance claims management Proven experience managing projects within: Medicare programs Medicaid systems Affordable Care Act (ACA) initiatives Employer-sponsored health plan implementations Proficiency in Agile/Scrum/SAFe project management methodologies Comprehensive knowledge of: Health insurance product structures Claims processing workflows Provider contracting principles Healthcare regulatory frameworks Demonstrated expertise in healthcare IT systems and technological implementations Preferred Qualifications: Experience working directly with: Health insurance payers Healthcare providers Regulatory agencies Background in claims migration programs Preferred Certifications: Project Management Professional (PMP) Program Management Professional (PgMP) Six Sigma Green/Black Belt Advanced Healthcare Management (AHM) Chartered Property Casualty Underwriter (CPCU) Compensation: Hourly W2 pay rate $100-110 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. 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) 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