- Are you an experienced Project Manager looking for a new challenge?
- Do you value care management and quality improvement?
- Are you motivated, energetic, and excited to become part of the Kepro team?
If so, you might be our next new team member!Note: This is a hybrid remote role where you can work from home, but there will be occasional office time.Who we need:
The Project Manager is responsible for operation of all contract duties to ensure that all contractual obligations are met. The Project Manager coordinates with the Department on decisions and issues and communicates with providers regarding determinations and other clinical matters. The Project Manager also develops and leads clinical staff in activities to facilitate and support clinical, quality, and cost-effective outcomes.Why us?
Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. People Focused. Mission Driven.
Shape the future of healthcare with us. We are mission driven to improve lives through healthcare quality and clinical expertise. We do this through our people.
At Kepro, you can do meaningful work that makes a real difference for the lives of individuals across the country. We are an organization that cares deeply about our employees and we provide the training and support to do the best work of your career.
Benefits are a key component of your rewards package at Kepro. These benefits are designed to provide you and your family additional protection, security, and support for both your career and your life away from work. They are comprehensive and fit a variety of needs and situations. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more. What you'll do:
What you'll need:Qualifications
- Oversee, coordinate, and monitor all Clinical team activities for the prior authorization review process.
- Ensure adequate staffing and contractual service levels are adhered to by implementing and monitoring clinical staff productivity and performance indicators. Maintains effective team member relations.
- Leads team members in improving skills, creativity, and problem-solving.
- Serve as liaison between the client and Kepro
- Attend Medicaid meetings, fair hearings, and meetings and hearings of legislative committees.
- Work with management team to develop and enhance the operational structure including skill set requirements, gap analysis, and training using workforce planning.
- Manages and completes assigned work plan objectives and projects on a timely basis.
- Provide advice and assistance to leaders in the planning, implementation, and evaluation of modifications to existing operations, systems, and procedures. Collaborate with leadership in the development of new and enhanced products and services.
- Represents the clinical department by participating on committees, task forces, work groups, and multidisciplinary teams.
- Maintains professional relationships with provider community and external customers and identifies opportunities for improvement.
- Participates in the development of policies and oversees clinical staff activities to ensure compliance with regulatory and accrediting standards, quality assurance and inter-rater reliability.
- Provides reports of compliance and oversight and reporting of contract required Service Levels.
- Maintain a positive relationship with our client, by developing ongoing communication and collaborative approach to delivery expectations.
- The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.
- Bachelor's Degree in Nursing Required, Master's in Nursing or other health-related field preferred
- Active unrestricted, RN license
Knowledge, Skills, Abilities
- 5+ years of clinical experience or equivalent
- 5+ years staff/workload management experience, strongly preferred.
- Experience with stated State Medicaid program
- Experience working with vulnerable populations, strongly preferred.
- Experience with utilization management reviews, strongly preferred.
- Demonstrated proficiency in MS Office applications.
- Ability to maintain a positive attitude and contribute both as an individual and a team member to achieve the goals of the department.
- Ability to professionally respond to change and handle multiple and changing priorities with sometimes conflicting deadlines.
- Knowledge and willingness to become a subject matter and thought leader for designated program(s).
We know your time is valuable and we thank you in advance for applying for this position. Due to the high volume of applicants we receive, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Kepro
and invite you to apply to future openings that may be of interest. Best of luck in your search!
~ The Kepro Talent Acquisition TeamMental and Physical Requirements
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. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state. EOE AA M/F/Vet/Disability
Kepro is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.