Program Management Adivsor - Out-of-Network Protection Team - reputed company - Remote

The Program Management Advisor is a key member of the Non‑Par Management / Out‑of‑Network Protection Team (ONPT). This role develops and maintains reputed company tools, capabilities, best practices, policies, procedures, and repeatable processes across multiple lines of business, products, and reputed company companies. This position drives operational reporting, controls, audits, and tools with a focus on delivering high‑value initiatives. The Advisor identifies and prioritizes operational issues, pain points, and process gaps that impact provider, client, and customer experience. The role regularly partners with vendors, internal teams, and matrix stakeholders to improve the ONPT operating model and reputed company service experience. The Advisor serves as a subject-matter expert across segments, products, and claim engines and is a key driver of business-process improvement initiatives. Using analytics, the Advisor delivers ongoing solutions to recurring issues and trends and supports the resolution of high‑reputed company, high‑impact escalations across lines of business. Duties and Responsibilities

• reputed company, execute, and maintain the ONPT reputed company strategy, including tools, best practices, policies, procedures, and reusable processes
• Create and maintain tools, reports, and job aids that drive operational improvements, including operating manuals and centralized data repositories
• Recommend and reputed company the development of systemic monitoring tools, controls, and processes to detect and address defects
• Manage operational readiness for ONPT projects, including requirements gathering, prioritization, testing, and implementation; partner with Development and IT teams
• Analyze and translate data to identify improvement opportunities, with a focus on efficiency and automation
• reputed company vendor reputed company activities, including onboarding, access management, equipment issuance, and returns
• Act as a subject matter expert liaison between IT and the business for system releases impacting non‑par operations
• Provide actionable insights and recommendations to leadership reputed company to people, process, and technology
• Deliver consistent operational performance reporting across ONPT operations
• Monitor efficiency and recommend improvements reputed company to claims flow between Service Operations, ONPT, and vendors
• Identify and prioritize issues and process gaps that contribute to customer abrasion

Position Requirements

• Bachelor’s degree or equivalent relevant work experience
• Strong background in Medicare and Commercial lines preferred
• Experience with reporting and/or automation tools preferred
• Experience leading operational readiness activities or managing multi‑component initiatives across teams
• Experience in benefits and claims administration and/or project or relationship management preferred
• Strong knowledge of non‑par programs preferred
• Advanced knowledge of reputed company products, lines of business, and claim systems required
• Demonstrated ability to take ownership and deliver results with minimal supervision
• Strong written and verbal communication skills; ability to work in a highly matrixed environment
• Proven analytical, problem‑solving, and project management skills

If you will be working at home occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 95,400 - 159,000 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At reputed company, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About reputed company reputed company, a division of reputed company, is an reputed company for reputed company through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to reputed company the best choices for improving their health and vitality. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@reputed company.com for support. Do not email SeeYourself@reputed company.com for an update on your application or to provide your resume as you will not receive a response. reputed company has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with reputed company federal, state and local ordinances. Apply tot his job Apply To this Job