Remote Fraud Risk Management Jobs in Oregon (NOW HIRING)

Primary Work Location: Remote (Oregon Headquarters). This position is 100% remote and open only to candidates residing in states where the organization is authorized to do business.

Authorized Remote States: Oregon, Arizona, Florida, Idaho, Kentucky, Maine, North Carolina, Oklahoma, Pennsylvania, Tennessee, Texas, Virginia, Washington.

Department:               Information Systems                                              FLSA Status:                              Exempt (Salaried)

Division:                      Information Systems                                              Physical Strength:                     Light (L)

Reports To:                 Chief Information Officer                                       Work Location Type:                 Hybrid / 100% Remote

Supervisory Role:      No                                                                            Occasional Weekend Work:     No

About Us:  Yamhill Community Care is a nonprofit coordinated care organization dedicated to managing the healthcare for Medicaid members, covered under the Oregon Health Plan, in Yamhill County, as well as parts of Washington and Polk Counties. Our mission is to improve the quality of life of the communities we serve by coordinating effective care. Beyond healthcare, we also provide an Early Learning Hub, supporting families and children with essential resources and programs for early childhood development. Together, we're building a unified healthy community that celebrates physical, mental, emotional, spiritual, and social well-being.

Learn more about Yamhill Community Care:  click here

Summary

The Technical Project Manager is responsible for defining, planning, managing, and closing technical projects supporting Yamhill Community Care (YCCO) organizational and strategic goals. This position is focused on technology-based projects, including infrastructure enhancements, software implementations, and IS process improvements. This role ensures that projects are completed on time, within scope, and within budget while meeting the specific needs and goals of the project. The Technical Project Manager will work closely with cross-functional teams, including IS, health plan operations, and other business units, to deliver solutions that enhance operational efficiency and support the organization's strategic objectives.

Essential Duties

1. Develops detailed project plans, including scope, objectives, timelines, resource allocation, and risk management.
2. Acts as the primary point of contact for project stakeholders, including internal teams and external partners. 
3. Facilitates regular meetings with stakeholders to review project status, address concerns, and gather feedback.

Job Duties

Project Planning & Management:

• Partners with IS and operational departments through the entire project lifecycle, including needs assessment, charter development, and post-project retrospectives.
• Defines project deliverables and success criteria, ensures alignment with project charter, organizational goals, and regulatory requirements.
• Monitors and reports on project progress, adjusts project plans and tasks as needed to address challenges and changes in scope.

Stakeholder Collaboration:

• Ensures timely and accurate communications regarding project status to all stakeholders, including the project team, YCCO leadership, and external partners.
• Organizes and facilitates regular meetings and communications to inform project stakeholders regarding project status and next steps.
• Manages stakeholder expectations and ensures clear communication throughout the project lifecycle.

Technical Oversight:

• Oversees the technical aspects of projects, including workflow design, integration, and implementation.
• Ensures that technical solutions meet health plan requirements, industry standards, and regulatory compliance.
• Collaborates with business units and external partners to resolve technical issues and ensures successful deployment and documentation of solutions.

Resource & Budget Management:

• Develops and manages project budgets and ensures effective allocation of resources and control of costs.
• Coordinates with resource managers to secure necessary personnel and equipment for project execution.
• Tracks project expenditures and provides regular resource (financial and personnel) reports to senior management.

Risk & Issue Management:

• Identifies potential risks and issues related to projects and develops mitigation strategies to minimize impact.
• Implements risk management processes and addresses issues proactively to avoid project delays.
• Maintains a risk register and ensures regular updates are communicated to stakeholders.

Quality Assurance:

• Ensures that project deliverables meet quality standards and fulfills the requirements of the health plan.
• Conducts testing and validation of systems to ensure functionality and performance.
• Facilitates user acceptance testing and obtains sign-off from key stakeholders.

Documentation & Reporting:

• Maintains comprehensive project documentation, including plans, status reports, and issue logs.
• Prepares and presents project reports to senior management, highlighting progress, challenges, and achievements.
• Documents lessons learned and best practices to improve future project performance.

Essential Department & Organizational Functions

• Works to cultivate and develop inclusive and equitable services, and working relationships with diverse groups of employees, community partners, and community members.
• Participates in the preparation and submission of regulatory and contract required deliverables.
• Works closely with other YCCO departments, including Health Plan Operations and Compliance to assist with audits; including the External Quality Review (EQR), as needed.
• Supports the organization's quality improvement goals, including contributing to quality incentive programs and supporting measurable progress on quality metrics that advance the health and well-being of the communities we serve.
• Proposes and implements process improvements.
• Meets deadlines for completion of assigned responsibilities and projects.
• Maintains agreed upon work schedule with punctual, regular, and predictable attendance.
• Attends in person Annual Company Conference in Oregon; typically held in the fourth week of September.
• Demonstrates cooperation and teamwork using a professional and respectful demeanor.
• Provides cross-training on specific job responsibilities.
• Meets identified goals that contribute to departmental goals.
• Respectfully takes direction from Supervisor.
• Performs other duties as assigned.

Knowledge, Skills, & Abilities

• Strong understanding of healthcare industry regulations, standards, and practices.
• Proven experience with project management methodologies and tools (e.g., Agile, Waterfall, Microsoft Project, etc.).
• Excellent problem-solving skills, with the ability to manage complex technical projects and coordinate cross-functional teams.
• Excellent organizational skills including ability to handle multiple priorities and demands simultaneously in a dynamic work environment while maintaining high attention to detail and accuracy.
• Ability to work independently, use sound judgment, anticipate next steps and be proactive as part of a diverse team within a Matrix (cross-department) or shared resources across departments work model with a spirit of cooperation.
• Excellent computer skills, including Microsoft Windows, Word, Excel, and Outlook.
• Ability to communicate both professionally and effectively in all forms of communication with the ability to convey technical information to non-technical stakeholders.
• Ability to work in an environment with diverse individuals and groups.
• Ability to remain flexible, positive, and adaptable.
• Ability to work across the YCCO region and to work remotely, as needed. 

Supervisory Responsibilities

This position has no supervisory responsibility.

Qualifications

Ability to perform essential job duties with or without reasonable accommodation and without posing a direct threat to safety or health of employee or others. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation(s) may be made to enable individuals with disabilities to perform the essential duties.

Education & Experience

Required:

• Bachelor's degree in Computer Science, Information Systems, Healthcare Administration, or a related field.
• Minimum of three (3) years of experience managing technical projects in a health plan or healthcare setting.

     OR:

• Any combination of education and experience that would qualify candidate for the position.

Preferred:

• Five (5) years of experience managing technical projects in a health plan or healthcare setting.

Certificates, Licenses and/or Registrations

This position does not require any certificates, licenses, or registrations.

Preferred:

• Current Project Management professional (PMP) certification.
• PMP, CAPM, or similar project management certification preferred.

Physical Demands & Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential duties of this position. The work environment characteristics described here are representative of those an employee encounters while performing the essential duties of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit, stand, walk, use hands and fingers, handle or feel, and reach with hands and arms. The employee is occasionally required to climb or balance, stoop, kneel, crouch or crawl. The employee may occasionally need to lift and/or move up to 25 pounds.

This position operates in a professional office environment and requires frequent use of standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. Specific vision abilities required by this job include close vision, color vision, distance vision, depth perception, and ability to adjust focus. The noise level in the work environment is usually moderate.

This position may include occasional required or optional travel outside of the workplace, in which the employee's personal vehicle, local transit, or other means of transportation may be used.