Job Title: Project Manager – Interoperability & Prior Authorization Initiative
Location: Quincy, MA (Hybrid)
Duration: 6 Months
Job Summary:
We are seeking an experienced Project Manager to lead the implementation of a federally mandated Advancing Interoperability and Improving Prior Authorization Processes initiative. This role focuses on enhancing care coordination among members, providers, and payers through the use of Application Programming Interfaces (API) and mobile applications. The Project Manager will oversee planning, vendor management, project execution, and ensure compliance with federal milestones in 2026 and 2027.
Key Responsibilities:
Serve as the primary point of accountability for the management and implementation of the interoperability and prior authorization initiative.
Oversee project management vendors to ensure deliverables align with objectives, timelines, and quality standards.
Facilitate acquisition of resources and coordinate cross-functional activities between stakeholders and external partners.
Lead workgroups of 30+ multidisciplinary team members to define business and technical requirements.
Develop and manage project plans, timelines, and deliverables while adapting to shifting priorities.
Conduct project meetings, provide updates, and prepare reports and presentations for stakeholders.
Monitor risks and issues, develop mitigation strategies, and track action items.
Ensure compliance with federal funding requirements, including reporting and invoice management.
Foster collaboration, innovation, and continuous improvement within the project team.
Manage stakeholder expectations, resolve conflicts, and build consensus among diverse groups.
Adhere to established project management policies, procurement standards, and compliance guidelines.
Qualifications & Experience:
5+ years of experience managing complex, cross-organizational technology projects within the healthcare industry.
Experience managing vendor contracts, preferably within healthcare IT, Medicaid, or Medicare.
Strong ability to build and maintain effective relationships across technical, business, and vendor teams.
Knowledge of Systems Development Life Cycle (SDLC) and Application Programming Interfaces (APIs).
Bachelor’s degree or equivalent.
Proven ability to manage large-scale projects ($1M+ budget, 20+ staff).
Strong communication, presentation, organizational, and interpersonal skills.
Ability to prioritize, work independently, and resolve complex problems.
Knowledge of healthcare compliance requirements such as HIPAA, Medicare, and Medicaid.
Preferred Skills:
Expertise in facilitating discussions, resolving conflicts, and driving team engagement.
Strong skills in eliciting and documenting business requirements.
Familiarity with the Massachusetts healthcare landscape is a plus.
Proficiency with MS Office (Excel, Word, Visio, Outlook, PowerPoint).
PMP or equivalent certification preferred.