Miami, Florida
Springfield, Missouri
Miami, Florida
Alamogordo, New Mexico
Posted: 26-Jun-26
Location: Los Angeles, California
Internal Number: 152567337
The Project Manager provides enterprise-level leadership and oversight for centralized clerical operations and correspondence services within a highly regulated healthcare environment. Reporting to the Faculty Practice Group (FPG) PSS Office Management leadership team, this role is responsible for the strategic direction, governance, compliance, and performance of complex programs supporting claims operations, mailroom services, billing correspondence, document processing, and OCR-enabled digital workflows. The project manager leads large-scale operational improvement initiatives, establishes performance standards and reporting frameworks, oversees OCR vendor operations, and ensures alignment with CMS regulations, health plan requirements, and organizational compliance standards. This position serves as a key liaison across Medical Group leadership, Health Plan executives, Faculty Practice Group departments, and external vendors to drive operational excellence, regulatory readiness, and organizational performance.
Key Responsibilities
- Lead the planning, implementation, monitoring, and optimization of programs supporting claims, mailroom, billing correspondence, and document processing operations.
- Establish program governance structures, performance standards, success metrics, and operational reporting frameworks.
- Identify operational risks, dependencies, and constraints, and implement mitigation and contingency plans.
- Conduct feasibility assessments, cost-benefit analyses, and operational impact evaluations for program initiatives.
- Drive process improvement and standardization efforts to enhance efficiency, quality, and compliance.
- Ensure compliance with CMS regulations, health plan contractual requirements, and internal organizational standards.
- Develop and maintain policies, procedures, and operational protocols that support scalable and compliant operations.
- Partner with organizational leaders to assess readiness, define resource requirements, and support implementation of new programs and process improvements.
- Provide executive-level reporting on program performance, operational risks, and strategic recommendations.
- Oversee OCR vendor operations, including performance management, service level monitoring, and contractual compliance.
- Identify opportunities to improve digital document processing workflows, operational efficiency, and service delivery.
- Analyze operational and financial data to identify trends, gaps, and opportunities for improvement and support data-driven decision-making.
- Program/Project management experience in a healthcare setting
- Demonstrated attention to detail and critical thinking skills. Demonstrated ability to determine relevance and prioritize tasks.
- Effective skill in tracking project progress.
- Skill in analyzing information, problems, situations and procedures to define objectives, identify patterns and formulate conclusions.
- Demonstrate capacity to identify gaps, anticipate obstacles and plan for contingencies
- Demonstrated ability to effectively communicate with all levels of an organization including senior leadership
- Effective problem-solving skills.
- Bachelor’s or equivalent combination of education and experience. MPH, MBA, MHA or other related Master’s degree preferred.
- Project Management Professional(PMP) Certification
- Lean Six Sigma / Certification
- Five years or more of related experience or training
- Five years or more of working in a Healthcare, Claims, CMS setting
- Strong understanding of Program/Project management principles, theories and concepts
