Location: Remote
Engagement Type: Contract
Industry: Health Plan / Managed Care
Description:
Impresiv Health is seeking an experienced Health Plan Operations Project Manager to support a large health plan in executing strategic and operational initiatives across the organization.
This role is designed for a hands-on project manager with direct knowledge of health plan operations who can translate leadership priorities into structured project plans, accountable workstreams, measurable milestones, and successful operational outcomes.
The ideal candidate has experience working within a payer environment and understands the interdependencies across key health plan functions, including claims, enrollment and eligibility, benefits, provider and network operations, member services, utilization and care management, finance, compliance, quality, analytics, vendors, and technology.
This is not a purely technical project management role. You will work closely with business and operational leaders to drive execution, identify dependencies and risks, resolve issues, and ensure initiatives progress successfully from planning through implementation and stabilization.
What You Will Do:
- Lead multiple concurrent health plan operational projects and initiatives from planning through implementation and stabilization.
- Translate executive and operational priorities into integrated project plans, milestones, deliverables, dependencies, owners, and timelines.
- Coordinate cross-functional work across Operations, Clinical, Claims, Enrollment, Provider/Network, Member Services, Finance, Compliance, Quality, Analytics, IT, and external vendors.
- Establish and maintain project governance, including status meetings, workplans, RAID logs, decision logs, action items, and executive reporting.
- Identify project risks, issues, dependencies, and resource constraints and drive them toward timely resolution.
- Facilitate working sessions with business owners, subject matter experts, technology teams, vendors, and leadership.
- Support operational readiness activities, including workflow development, SOPs, testing and UAT, training, communications, cutover planning, and go-live readiness.
- Track implementation progress and ensure accountable owners understand commitments, deadlines, and dependencies.
- Coordinate vendors and third-party partners supporting project delivery.
- Prepare concise executive-level status reports and escalate decisions requiring leadership intervention.
- Support the transition of completed initiatives into sustainable business operations and post-implementation stabilization.
- Bring structure, accountability, and clarity to initiatives where requirements, ownership, or priorities may still be evolving.
You Will Be Successful If:
- You can quickly understand a health plan's operational environment and begin driving work with limited direction.
- You are comfortable asking difficult questions, clarifying ownership, and identifying risks that could affect critical milestones.
- You can bring together operational, clinical, technical, and vendor stakeholders to maintain alignment and momentum.
- You effectively manage multiple priorities and dependencies across matrixed teams.
- You can turn complex project activity into clear, actionable updates for senior leadership.
- You understand that successful project management requires more than tracking tasks and can actively drive decisions, accountability, operational readiness, and execution.
- You approach the role as a health plan operator who is also an excellent project manager, rather than simply a project manager with healthcare project experience.
What You Will Bring:
- 7+ years of project or program management experience, preferably within healthcare or managed care.
- Demonstrated experience working within a health plan or directly supporting payer operations.
- Experience supporting Medicare Advantage, Medicaid, D-SNP, Commercial, or other managed-care lines of business.
- Working knowledge of multiple core health plan functions, such as claims, enrollment and eligibility, benefits, provider operations, member services, utilization management, care management, finance, compliance, or quality.
- Experience managing complex, cross-functional initiatives involving both business and technology stakeholders.
- Strong knowledge of project governance, integrated workplans, dependency management, RAID management, operational readiness, testing/UAT, implementation, and stabilization.
- Experience working with senior executives and independently driving accountability across matrixed teams.
- Strong written and verbal communication skills with the ability to translate complex project activity into clear executive-level reporting.
- Experience managing vendors, consultants, or system implementation partners is preferred.
- PMP or a comparable project management certification is preferred.
About Impresiv Health:
Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services. We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges.
Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do – provide tangible results that add immediate value, at a rate that cannot be beaten. Your success matters, and we know it.
That’s Impresiv!