Clinical Initiatives Senior Program Manager Job in San Francisco 94105, California US
Modis is working with one of their clients to fill a Clinical Initiatives Senior Program Manager role in San Francisco, CA. This is a 5-12 month contract-to-hire opportunity. If you are interested or know someone who may be, please e-mail an updated resume to chris.shaw@modis.com
Listed below includes the job description and if you would like to learn more about Modis, please click the following link: www.modis.com/itrecruitment
Position Description:
Summary:
Clinical Initiatives Senior Program Manager Role
• Provide supervision to direct reports, responsible for overall performance of team in improving HEDIS and clinical performance outcomes.
• Ensure that best practices are followed and develop innovative approaches to improve member receipt of appropriate preventive and chronic care services.
• Develop program including goals, activities and reporting structure to assess progress, barrier identification and recommendations for improved outcomes.
• Direct assessment activities to determine overall and cost effectiveness of interventions
• Develop and provide oversight of the plan, program and budget
• Recruit, select and provide oversight of vendor management of external vendors contracted by the QI team.
• Responsible for identification of, chartering and assignment of new projects with assigned Business Project Manager, and provision of progress reports on clinical improvement initiatives and projects to QI Director and Quality Committees
• Provide direction and oversight of timeliness and completeness of claims and encounter data.
• Direct the identification and development of business requirements for new data opportunities and maintain relationships internally and externally for access.
• Provide leadership to the QI and Core Team to prioritize, define and develop a business case for related quality improvement initiatives.
• Participate with QI Department Program Managers, Medical Informatics (MI), QI Project Manager and QI Data Analyst to craft QI reporting requirements.
• Provide oversight and direction to the annual HEDIS pursuit plan for capture of compliant/non-compliant provider and member data by Clinicians for hybrid measures.
• Assess attainment of goals real-time and ensure work flow or process changes are conducted to attain success.
• Lead process improvement team(s) including IT, MI, QI and others to make changes that will lead to better and more cost-effective HEDIS and clinical outcomes.
Quality Improvement Program Summary and other materials
• Partner with other individuals within the organization to write an annual summary suitable for members, providers and employees.
• Partner with others within the organization in the development of other quality materials that can be used for presentations, reports, internal and external communications
Other duties as assigned
• Provide support to and participate in accreditation and internal/external quality reviews.
Required Knowledge and Skills
• Experienced in complex program and program management linked to clinical outcomes and population based initiatives
• Team management, including Clinical staff
• Ability in interact with all disciplines in health care environment
• Computer literate including: Word, PowerPoint, Excel and MS Access database, experience in a MCO data-driven environment required
• End user reporting tools and dashboards
• Knowledge of health care terminology and basic medical practices
• Familiar with HEDIS pursuit and data collection required, experience in data collection in a capitated provider environment preferred
• Excellent verbal and written communication skills
• Competency with social media applications to drive member engagement a plus.
Leadership Competencies
• Knows how managed care health insurance companies and businesses assure success by using data to drive sound decisions.
• Is able to translate the organization’s and department’s strategic objectives into initiatives to meet those objectives.
• Establishes high standards for self and others and knows how to positively motivate internal and external stakeholders to achieve those same standards. Is tenacious and creative in working around and through barriers.
• Demonstrates maturity and is able to maintain composure and serve as an example of professionalism especially when in a stressful situation.
• Is objective, a good listener and partner in problem-solving and reaching consensus.
• Considered a trusted team member and co-worker, takes responsibilities seriously and delivers as promised.
• Keeps up-to-date with the industry and shares knowledge effectively, understands the influence of change to the organization as a whole.
Licensure
• Current clinical licensure preferred but not required.
Level of Education
• Bachelor’s Degree required; Master’s Degree in Business, Public Health or Administration preferred.