Health Management Systems, Inc. Ultilization Review Project Manager in Westerville, Ohio

HMS makes the healthcare system work better for everyone. We fight fraud, waste, and abuse so people have access to healthcare—now and in the future. Using innovative technology and powerful data analytics, we help government and commercial payers reduce costs, increase quality, and achieve regulatory compliance. We also help consumers take a more active role in their own health. Each year, we save our clients billions of dollars while helping people live healthier lives. At HMS, you will develop new skills and build your career in a dynamic industry while making a difference in the lives of others.

We are seeking a talented individual for a Project Manager who is responsible for managing the activities for assigned contract(s) including establishing and monitoring timelines, obtaining and coordinating resources, and ensuring client deliverables meet quality standards. Responsible for ensuring contract requirements are being fulfilled.

Essential Responsibilities:

  • Manages team members to ensure timely and quality deliverables in support of assigned contract(s). Hires, trains, and supervises staff assigned to contract(s) including performance management.

  • Works directly with client including addressing questions, hosting meetings, providing status reports, etc.

  • Prepares outcome reports that show findings from project/contract activities. Effectively communicates project finding to internal and external clients.

  • Works with external and internal sources in order to meet contract expectations.

  • Performs quality assurance checks on client deliverables.

  • Serves as a resource to participants in project/contract activities.

  • Supports business development efforts through contributions to presentations and proposals, as needed.

  • Maintains professional competencies and knowledge for project, community relations, and customer service responsibilities as necessary for project.

  • Prepares presentations and reports in concert with contract deliverables.

  • Analyzes health care and clinical data.

Non-Essential Responsibilities:

  • Performs other functions as assigned

Knowledge, Skills and Abilities:

  • Ability to become familiar with laws and practices as it related to impatient DRG reimbursement, medical records request and overpayment recovery preferred.

  • Ability to generate reports with MS Office Suite and work proficiently with Microsoft Word and Excel.

  • Ability to provide excellent interpersonal and communication skills (both written and oral) in English.

  • Working knowledge of basic health care data analysis and clinical review.

  • Working knowledge of HIPAA privacy and Security rules.

  • Ability to multi-task and prioritize.

  • Ability to be careful and thorough about detail.

  • Ability to analyze information and use logic and process to address work-related issues and problems.

  • Ability to organize well.

  • Ability to work independently to meet objectives.

  • Ability to meet deadlines.

  • Ability to perform well in team environment, with staff at all levels, to achieve business goals.

  • Ability to handle pressure and deadline oriented project demands as well as manage multiple initiatives.

  • Ability to perform oral presentations with good quality.

  • Ability to troubleshoot existing applications.

Work Conditions and Physical Demands:

  • Primarily sedentary work in a general office environment

  • Ability to communicate and exchange information

  • Ability to comprehend and interpret documents and data

  • Requires occasional standing, walking, lifting, and moving objects (up to 10 lbs.)

  • Requires manual dexterity to use computer, telephone and peripherals

  • May be required to work extended hours for special business needs

  • May be required to travel 100% of time based on business needs

Certifications: (Required/Desired)

  • RHIT/RHIA/RN certification required

Minimum Education:

  • Bachelor’s degree in Health Information Administration or the equivalent required

Minimum Related Work Experience:

  • 3 yrs professional experience in a clinical environment.

  • 2 yrs project management experience required.

  • Experience providing testimony desired.

  • Experience in customer service, provider relations or client management required.

  • DRG coding and review experience preferred.

Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

Title: Ultilization Review Project Manager

Location: Ohio-Westerville

Requisition ID: 1800112B

EEO/Minorities/Females/Protected Veterans/Disabled.