Project Manager – Managed Care

Project Manager – Managed Care

Posting Date: December 16, 2025

Location: Integrity House - Newark

Integrity House is New Jersey’s oldest active nonprofit provider of compassionate care for individuals and families experiencing addiction and mental health conditions. Founded in 1968, we operate 18 licensed treatment programs, community outreach and prevention programs, and serve over 7,000 individuals each year. Our goal is to provide comprehensive, whole‑person care options under one unified system of care.

Manage the transition of billing processes from the current fee‑for‑service model to MCO billing requirements, ensuring accurate and timely claim submission. Ensure all providers are properly enrolled with state Medicaid, monitor that all MCO contracts and associated billing rates meet or exceed previously identified FFS floor rates, resolve claims processing issues, analyze reimbursement trends, and optimize revenue cycle performance.

Ensure all project activities adhere to healthcare industry regulations and standards, including HIPAA, CMS, and Department of Health guidelines. Oversee policy and workflow updates; ensure system changes support claims processing, benefits administration, utilization management, and care coordination.

Conduct detailed research on the NJ Medicaid market and regulatory landscape to identify growth opportunities and assess impacts on the operating model. Analyze competitor strategies and state policy to discern new business opportunities and partnerships. Plan, organize, monitor, and oversee complex projects related to new Medicaid managed care.

Coordinate operational teams to translate contract requirements, market intelligence, and industry best practices into viable target operating models. Build and maintain strong relationships with potential stakeholders, partners, including NJ state agencies and regulators.

Act as key liaison, driving collaboration between internal cross‑functional teams (clinical, IT, operations, finance, etc.), external partners, state officials, and vendors to ensure clarity regarding information and requirements.

• Bachelor’s degree in a related field, e.g., public health or healthcare administration, required.
• Experience in business development or strategy consulting within the managed care sector.
• Two (2) years’ experience with systems related to claims, benefits, and utilization management.
• Strong communication, analytical, and problem‑solving skills.
• Ability to work independently and collaboratively to manage deadlines and adapt to changing priorities.

Monday – Friday, 9:00 am‑5:00 pm, with the ability to work outside of standard working hours.

We believe work is more than a place you go every day. It is about being inspired and motivated to achieve extraordinary things. We provide a workplace that offers variety, presence, and development, along with a multitude of staff benefits to ensure the wellbeing of our teams.

• Low‑cost and generous medical and prescription coverage.
• Employer‑paid dental.
• Employer‑paid vision.
• Employer‑paid life and AD&D.
• Employer‑paid long‑term disability.
• Employer‑paid Health Reimbursement Account.
• Generous vacation, sick, personal and holiday time.
• 403(b) plan with a dollar‑for‑dollar match up to 3% of compensation.
• Employee Assistance Plan.
• Flexible Spending Account.
• Commuter Benefit Plan.
• Tuition Reimbursement – up to $4,000 annual.
• Recognition Rewards.
• Professional Development Opportunities.

Integrity House is New Jersey’s oldest provider of comprehensive substance use and mental health services. We offer a full suite of treatment options, including substance use disorder, mental health, gambling addiction, physical health, education and employment readiness support, care coordination, creative arts therapy, supportive housing, recovery programs, and community outreach services. Accredited by the Commission on Accreditation of Rehabilitation…