PROJECT SPECIALIST - HEALTHCARE - REMOTE

iMPROve Health is Michigan’s Medicare-designated Quality Improvement Organization and a nonprofit focused on improving healthcare quality and efficiency through evidence-based, data-driven strategies. The Project Specialist supports the Federal Independent Dispute Resolution Entity (IDRE) review process by managing daily administrative workflow and helping ensure cases progress on time. This role collaborates closely with the IDRE team, reviewers, and external customers to secure complete documentation and support timely reviews.

• Facilitate review requests in a timely and efficient manner, including implementing processes to track and monitor case progress and timeliness.

• Collaborate with IDRE team members to achieve department goals, including prescreening IDR cases for eligibility using defined criteria.

• Apply knowledge of claims, appeals, and denials to support review and resolution processes with accuracy, compliance, and timeliness.

• Coordinate, document, and track data to meet informational and reporting needs using various applications and claims/review portals.

• Work with the administrative assistant to ensure receipt and completeness of review documentation and follow up with external customers as needed.

• Develop and maintain materials such as forms, email correspondence, manuals, articles, lists, invoices, charts, matrices, reports, records, schedules, templates, and similar documents.

• Organize and support team planning and coordination of meetings, workshops, programs, presentations, conferences, and other events.

• Use advanced computer skills with constant computer usage, including Microsoft Office, Windows products, and web-based portals.

• Participate in portal development and enhancements by performing testing and providing feedback to improve functionality and user experience.

• Adhere to compliance regulations including HIPAA, FISMA, URAC, CMS requirements, and FAR.

• Complete other duties as assigned.

• Associate’s degree or five (5) years of related experience (required); Bachelor’s degree preferred (healthcare specialty preferred).

• Minimum two (2) years of project support experience in a corporate or professional environment (required).

• Experience with IDR or claims, appeals, and denial processes (preferred).

• Project management skills (required).

• Strong verbal and written communication skills (required).

• Strong multitasking skills with attention to detail and deadlines (required).

• Core competencies: attention to detail, reliability, communication, collaboration, accountability, time management, and problem-solving.

• 100% remote; work from anywhere in the United States.

• Benefits include medical, dental, vision, life insurance, short- and long-term disability, and a generous 401(k) match.

• Professional development and continuing education opportunities; emphasis on work/life balance.