Remote Senior Project Solution Manager (Utilization Management) – LPN/LVN, RN

Job Overview

  • Clinical License LPN, RN
  • State(s) Nationwide


Job Description Summary


Responsible for the management of a variety of projects for corporate and/or strategic business unit (SBU). Provides support through the planning and execution of these projects. Support may include establishing deadlines, assigning resources/responsibilities and monitoring and summarizing progress of projects. Prepares reports for upper management regarding status of project. Familiar with a variety of the field’s concepts, practices, and procedures.


Job Description

This position with take the lead in working with executive management team on priority initiatives designed to improve operations and meet key customer deliverables. Serves as liaison between departmental team business owners, end users, IT, Claims and Clinical departments. This role will provide program expertise, project management planning, execution and reporting to individual project teams, leadership, and the executive team. Responsible for ensuring projects are within scope and meet time and budget targets. Will participate in full life cycle development by performing requirements analysis, process development, solutioning, and post-production validation. Collaborates with functional teams, as well as with IT iteration managers and product owners to develop detailed design specifications according to standards.


  • Manages all operational aspects of a project and scope.
  • Meets with business process owners and key stakeholders to identify the project’s goals, objectives, critical success factors, and success measures.
  • Creates and executes project work plans and revises as appropriate to meet changing needs and requirements.
  • Tracks and assigns resources needed and oversees individual responsibilities.
  • Review’s deliverables prepared by team before passing to project team members or account management.
  • Effectively applies Magellan’s methodology and enforces project standards using Microsoft Office Suite, specifically Excel and Visio or other approved toolkit templates.
  • Minimizes our exposure and risk on projects, and appropriately raising awareness on at-risk items.
  • Ensures project documents are complete, current, and stored appropriately.
  • Participates in enterprise-wide project planning and strategy planning as required.
  • Provides status reporting to stakeholders on a regular basis. Apprises management of issues requiring resolution to maintain progress on a timely basis.
  • Leads in the establishment and facilitation of program management processes and tools.
  • Conducts lessons learned to continually improve processes.
  • Contributes to, implements, and maintains best practices and project management policies and guidelines.
  • Develops and maintains relationships within client that includes high level consultation and support to meet the clients’ business needs.
  • Demonstrates knowledge of the clients’ products and services and how multiple products and services are interdependent within the customer contract deliverables.
  • Develops and documents workflow, systems requirements, system impact analysis, process analysis, conducts post-production validation, and cost-effective solutions as directed.
  • Identifies impact of solutions on existing and future systems.
  • Creates and maintains internal management tools, workflow business rules and system configuration, and document management requirements.
  • Conducts root-cause analyses, gathering data to pinpoint problem areas on which to focus, validating that the analysis is data driven, recommending, and implementing solutions and evaluating those results, and implementing controls to
  • monitor consistent use of the solution.
  • Participates in program design plans for implementation and produces appropriate project documentation.
  • Identifies reporting needs based on system configuration and workflows and documents reporting requirements.
  • Participates in initiatives or projects that support process improvements, leveraging new system capabilities or the
  • integration of data/other applications into existing systems.


Minimum Qualifications


7+ years of project management or job related experience in a medium to large-scale corporation.

  • Bachelor’s degree in Business Administration, Business Management, or any other related field required or an equivalent of this requirement in directly relatable work experience is also acceptable.


Preferred Qualifications

  • Advanced knowledge of project management practices and methodologies.
  • Successful track record of delivering projects within scope and on time with superior results.
  • Proven ability to plan, organize, schedule, direct, control and monitor project activities.
  • Well-developed interpersonal skills.
  • Self-directed and motivated with strong analytical skills, systematic and orderly planning abilities, and high attention to detail.
  • Excellent verbal and written communication skills.
  • Proven ability to evaluate key business objectives and develop appropriate action plans from multi-disciplinary perspectives.
  • Proficiency in Microsoft Office suite, specifically Excel and Visio.
  • Analytical/problem solving skills, excellent verbal and written communication skills, strong PC background, efficient in
  • using standard software.Knowledge of system process analysis and/or program management, estimating IT system development and testing.



  • For clinical related roles, clinical licensure (e.g., LPN, RN, LCSW, LMSW) is preferred.
  • 7+ years of project management or job related experience in a medium to large-scale corporation.
  • Bachelor’s degree in Business Administration, Business Management, or any other related field required or an equivalent of this requirement in directly relatable work experience is also acceptable.
  • Strong working knowledge of Microsoft Product Suite, specifically Excel, Access and Visio.
  • Knowledge of project management practices and methodologies.
  • Knowledge of process improvement methodologies.
  • Ability to develop and maintain multiple project plans.
  • Financial Management knowledge; understands basic financial model and budgeting.
  • Facilitation and interpersonal skills with the ability to work effectively with cross-functional teams.
  • Basic knowledge of health care management.
  • Proven ability to plan, organize, schedule, direct, control, and monitor project activities.


Work Experience

Work Experience – Required:

Project/Program Management


Work Experience – Preferred:



Education – Required:

A Combination of Education and Work Experience May Be Considered., Bachelors – Business Administration


Education – Preferred:




Certifications – Required:


Certifications – Preferred:

LSSGB – Lean Six Sigma Green Belt Certification – Enterprise – Enterprise, PMP – Project Management Professional – Enterprise – Enterprise



Potential pay for this position ranges from $80,920.00 – $129,480.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.


To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the “Benefits at a glance” button for more detail.



Prime Therapeutics LLC is an Equal Opportunity Employer and a Tobacco-free workplace. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected class under federal, state, or local law. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.


Positions will be posted for a minimum of five consecutive workdays.





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