GENERAL JOB DUTIES AND RESPONSIBILITIES:

To perform the job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Project Management & Leadership:

Leads and manages complex TPA projects from initiation through completion, ensuring timely delivery and quality
Assist in developing project plans, timelines, and resource allocation strategies for departmental
Serves as a liaison between technical teams, vendors, and internal stakeholders for major

Technical Coordination:

Coordinates, prioritizes, and follows up on programming requests for software maintenance and
Follow up with administrative staff to ensure that the testing has been done and results submitted in
Evaluates and recommend system improvements and process
Assists in implementation of new products and/or carriers within the TPA, including training and
Troubleshoots complex technical issues and collaborates with IT teams to resolve system

Reporting & Analytics:

Creates and maintains weekly reports to track Service Request Ticket statuses and project
Develop monthly and annual reports for accounting, compliance, and executive
Analyzes data trends and provides actionable insights to improve operational

Communications & Administration:

Creates, edits, reviews, and approves TPA communications located in the administrative
Develops and maintains standard operating procedures and documentation for the
Assists the Product and Data Manager with strategic administrative tasks and special

Process Improvement:

Identifies opportunities for process improvements and implements
Develop training materials and conduct training sessions for new systems and
Ensures quality control and compliance with company policies and industry
Performs other duties as assigned by the Product and Data Manager or the Senior Project

EXPERIENCE AND EDUCATION REQUIREMENTS:

High School Diploma required; Associate's degree required, Bachelor's degree
Minimum3-5yearsofexperienceinprojectcoordination,administration,orrelatedfield(TPA/healthcare experience strongly preferred).
Proventrackrecordofsuccessfullymanagingmultiplecomplexprojects
Musthaveexceptionalcommunication,leadership,andorganizationalskillswithabilitytomultitask
MusthaveexcellentcomputerskillswithadvancedexperienceinMicrosoft
Advancedskill levelsinMicrosoftExcel,Word,PowerPoint, and Outlookare
Experiencewithprojectmanagementmethodologiesandtoolsis
Must possess strong time management, organizational, problem-solving, analytical, and customer service
Demonstratedabilitytoworkindependently,takeinitiative,andmakesound
Mustbeabletoworkwellunderpressurewithmultipleprioritiesandmeetdeadlineswhilemaintaining strong attention to detail.

WORKING ENVIRONMENT:

Must be able to perform in a very high-paced environment and be flexible to multi-task or handle
Ability to work independently with excellent time management skills and minimal
Ability to prioritize and work on multiple complex projects while completing deadlines in an organized
Excellent problem-solving and critical thinking skills along with keen attention to
Strong written and verbal communication, interpersonal, leadership, and relationship building
Ability to handle stressful situations appropriately and maintain composure under
Ability to maintain confidentiality and privacy in every aspect of the
Demonstrates sound judgment and decision-making in ambiguous

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