Project Manager - Managed Care (Remote)

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Day - 08 Hour (United States of America)

This is a Stanford Health Care job.

A Brief Overview
The Project Manager – Managed Care leads complex initiatives that directly support Stanford Medicine's payer contracting, provider network participation, and managed care operations. This role is accountable for driving projects from strategy through execution, ensuring timelines, financial objectives, regulatory requirements, and operational readiness are met.

The Project Manager partners closely with Managed Care leadership and cross-functional stakeholders to implement contracting initiatives, oversee regulatory and compliance-related workstreams, and manage vendor performance. Projects managed in this role have direct impact on net patient revenue, payer performance, and enterprise contract administration.

This position operates with significant independence and visibility, requiring strong judgment, stakeholder alignment, and disciplined execution across high-impact initiatives.

Locations
Stanford Health Care

What you will do

• Project Coordination/Management

• Lead and coordinate cross-functional projects, ensuring alignment with organizational goals and regulatory requirements.

• Develop and maintain detailed project plans, timelines, and tracking tools to support successful execution.

• Monitor project progress, manage documentation, and provide regular status updates and reporting.

• Analyze project data and generate reports to support decision-making and performance tracking.

• Support process improvement initiatives by developing and refining workflows and tools.

• Prepare presentations, written communications, and web content related to assigned programs or initiatives.

• Maintain organized program documentation and ensure accuracy and accessibility of project records.

• Conduct business research and analysis to inform project planning and strategy.

• Collaborate with internal stakeholders across departments to support project objectives and ensure effective communication.

• Provider Data Maintenance

• Support enterprise-wide provider data management across multiple affiliated entities, including Stanford Health Care Faculty, Lucile Packard Children’s Hospital Faculty, Stanford Medicine Partners (foundation),Packard Children’s Health Alliance (foundation). Ensure accuracy, completeness, and integrity of provider demographic, affiliation, and network participation data across internal systems and contracted payers.

• Perform routine audits and data validation to maintain alignment between credentialing, contracting, enrollment, and operational systems; proactively identify and resolve discrepancies to reduce compliance and reimbursement risk.

• Generate, analyze, and distribute provider data reports to support managed care operations, contracting, compliance, network management, and executive leadership decision-making.

• Develop and maintain standardized processes for provider roster management, including file preparation, submission, and reconciliation with health plans.

• Ensure all provider directories and externally distributed rosters comply with applicable state and federal regulations (including SB137), CMS requirements, and individual health plan contractual obligations.

• Collaborate cross-functionally with credentialing, managed care contracting, compliance, IT, and operations teams to support regulatory audits, health plan inquiries, and provider data accuracy initiatives.

• Contract Maintenance

• Maintain and update the enterprise contract management database, ensuring accuracy, completeness, and consistency of all contract records across Stanford.

• Serve as the primary administrative point of contact and subject matter expert for the contract management system.

• Create, manage, and monitor user accounts and system access to ensure compliance with internal controls and data governance standards.

• Oversee vendor performance and fulfillment of contractual obligations related to enterprise contract management systems.

• Support workflow optimization, system enhancements, and continuous improvement initiatives to improve efficiency and data integrity.

• Ensure adherence to established policies, procedures, and best practices in contract documentation and recordkeeping

Education Qualifications

• Bachelor’s degree in healthcare administration, business, finance, or a related field required. Relevant experience in lieu of a degree may be considered.

Experience Qualifications

• Four (4) years of progressively responsible and directly related work experience required.

Required Knowledge, Skills and Abilities

• Advanced proficiency in Microsoft Excel; experience with data visualization and reporting tools preferred.

• Strong written and verbal communication skills, including the ability to prepare executive-level presentations and reports.

• Solid understanding of project management principles, with the ability to manage multiple high-impact initiatives and competing priorities.

• Ability to analyze complex information, interpret and apply a broad range of policies and procedures, and maintain a strategic, big-picture perspective.

• Demonstrated ability to exercise independent judgment and make sound decisions.

• Ability to build and maintain effective working relationships with internal and external stakeholders, communicating professionally and effectively (including use of C-I-CARE principles).

These principles apply to ALL employees:

SHC Commitment to Providing an Exceptional Patient & Family Experience

Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford’s patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.

You will do this by executing against our three experience pillars, from the patient and family’s perspective:

• Know Me: Anticipate my needs and status to deliver effective care

• Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health

• Coordinate for Me: Own the complexity of my care through coordination

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

Base Pay Scale: Generally starting at $55.85 - $74.00 per hour

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.