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Senior Program Manager

2 months ago

Bloomington, Illinois, United States CATHEXIS Full time
Job Title: Senior Program Manager

We are seeking a highly skilled Senior Program Manager to join our team at CATHEXIS. As a Senior Program Manager, you will be responsible for overseeing the entire project lifecycle of the MDE Audit under minimal supervision, ensuring successful progression from initiation to completion.

Key Responsibilities:
  • Oversee the entire project lifecycle of the MDE Audit, ensuring successful progression from initiation to completion.
  • Demonstrate exceptional multitasking capabilities in a fast-paced environment, meeting critical deadlines and achieving project milestones.
  • Guarantee the timely and accurate delivery of weekly and monthly project outputs, emphasizing their quality, completeness, and precision.
  • Lead the project with strategic oversight, ensuring effective management, direction, and execution of all tasks.
  • Manage the project team, fostering a collaborative environment and ensuring efficient task allocation and performance.
  • Monitor project execution, manage changes effectively, and maintain team cohesion, ensuring alignment with project objectives.
  • Quickly identify and address any deviations from the project plan, implementing corrective actions to meet client requirements.
  • Enhance quality control processes throughout the project, from planning to execution and reporting, to ensure excellence in delivery.
  • Oversee the project's financial aspects, including budgeting, forecasting, and managing any variances, and develop strategies to address financial challenges.
  • Report project status to senior leadership on a monthly basis, providing insightful updates on progress and challenges.
  • Ensure strict adherence to VA policies, company procedures, and regulatory requirements throughout the project lifecycle.
  • Conduct independent evaluations of medical records and claims to identify potential fraud, waste, and abuse, using a comprehensive understanding of medical procedures, Medicare policies, and coding guidelines.
  • Utilize expertise in coding conventions, fraud detection, reimbursement practices, and relevant laws to identify irregular billing patterns.
  • Maintain a deep knowledge of applicable regulations, coding standards, and VA policies, applying this understanding to perform criteria-based audits.
  • Prepare detailed audit documentation and working papers in line with GAGAS standards, reflecting thorough fieldwork and conclusions.
  • Collaborate with team members to define project requirements, validate findings, and ensure the accuracy of audit results.
  • Assist in the development of written summaries of audit results, contributing to formal reports and presentations.
  • Conduct root-cause analyses to identify underlying issues and recommend both corrective and preventative measures for continuous improvement.
Requirements:
  • Possess a Bachelor's or Master's degree in a relevant field.
  • A minimum of eight years of experience in project management, with a strong preference for candidates with a background in healthcare, specifically in records management, patient administration, or clinical operations.
  • Demonstrated experience in conducting audits in line with professional standards and best practices within the industry is essential.
  • In-depth knowledge of government payer practices, guidelines, and procedures is required, including familiarity with CPT, ICD-9, ICD-10, and HCPCS coding systems.
  • Background in healthcare auditing, regulatory compliance, or a relevant combination of education and experience will be considered.
  • Exceptional communication skills are mandatory, with proficiency in both verbal and written forms, as well as in using MS Word, Excel, and PowerPoint.
  • Ability to manage multiple tasks of varying complexity within tight deadlines, thriving in a fast-paced and dynamic work environment.
  • Eligibility to obtain a Veterans Affairs Public Trust Clearance, requiring a successful completion of a NACI background investigation.
Benefits:
  • Performance Bonuses
  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • 401(k) Plan (Traditional and ROTH)
  • Life Insurance (Basic, Voluntary & AD&D)
  • Paid Time Off
  • 11 Federal Holidays
  • Parental Leave
  • Commute Benefits
  • Short Term & Long Term Disability
  • Training & Development
  • Wellness Program
  • Community Outreach Initiatives

CATHEXIS is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact the appropriate personnel office.