Posted 1 week ago

WINTrio LLC

About the Role
We are seeking an experienced Project Manager to lead a multi-disciplinary team supporting a major federal healthcare program initiative. The ideal candidate will hold PMP certification from the Project Management Institute and have at least 5 years of managing complex projects, including cross-functional coordination, stakeholder engagement, and schedule/budget oversight. In this role, you will manage program teams engaged in tasks such as risk-adjustment data validation, geographic classification review, legal analyses, case management, medical record review, and appeals processing.
Key Responsibilities
• Lead and manage the project from initiation through close-out, coordinating team members across legal, compliance, medical coding, audit, data, IT and support functions.
• Manage legal analysis and statutory interpretation efforts and coordinate production of legal recommendations and decision-writing deliverables.
• Direct case-management workflows: intake, eligibility, appeals or requests processing, escalation procedures, issue analysis and resolution.
• Supervise medical record reviews and medical coding efforts.
• Utilize and oversee platforms like Salesforce (or analogous CRM/case management systems) for tracking cases, workflows, escalations and reporting.
• Develop and drive program-management best practices: create status reports, risk/issue logs, change-control documentation, resource plans, budget monitoring, and communication plans.
Required Qualifications
• Minimum 5 years of project management experience leading multi-disciplinary teams in a government, healthcare, auditing or appeals environment.
• Demonstrated experience with healthcare risk adjustment, provider reimbursement reviews, audit or appeals program management.
• Proven legal analysis and decision-writing experience (legal briefs, memoranda or similar).
• Familiarity with Salesforce or other CRM/workflow systems for case and project tracking.
• Strong program management skills: schedule/budget oversight, risk/issue management, resource coordination, status reporting.
Application Instructions
Please submit your resume, a short cover letter, and any relevant project highlights via LinkedIn or email Capture@wintrio.com.

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