Project Manager- Consultant I

Overview

Overview: 

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.

Key Responsibilities:

• 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.

Skills & Competencies:

• 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.

Geographic Responsibility: Remote, US

Type of Employment: Full-time, permanent 

FLSA Classification (USA Only): Exempt 

Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:  

• 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. 

The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990.  Candidates may be required to go through a pre-employment criminal background check. 

HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities.