Program Manager, Quality Initiatives (Remote)
Program Manager, Quality Initiatives (Remote)
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Job Summary
WellBe is a Physician Led Advanced Practice clinician driven geriatric care (care of older adults) team focused on the care of the frail poly-chronic elderly Medicare Advantage patients. This population is typically undeservedand very challenged with access to care. To address these problems we have elected to bring the care to the patient instead of trying to bring the patient to the care. Care is provided throughout the entire continuum of care from chronic care and urgent care in the home to hospital to skilled nursing facility to assisted living to palliative care to end of life care. WellBes care teams partner with the patients primary care physician to provide concierge level geriatric medical care and social support in the home as well as delivering and coordinating across the entire care continuum.
Job Description
Program Manager for Quality Initiatives will support corporate and local regional leadership in achieving key clinical and quality results to ensure improvement and sustainability of HEDIS Medication Adherence and overall STARS performance for assigned market. You will function as an SME leading quality initiatives in a fast-paced environment and be responsible to identify / integrate best practices develop performance improvement plans and supporting local markets in meeting enterprise goals. This position requires high degree of NCQA HEDIS and Medicare Star Rating knowledge ability to prepare and present program results to senior management analyze large volume of data develop reporting and function within a highly matrix environment.
SKILLS & COMPETENCIES
- Strategy: Assist in the development of local program strategy and lead execution of projects that ensure alignment with enterprise-wide quality / STARS goals and performance improvement. Remain aware of industry trends and integrate best practices into state programs.
- Training: Assist in the development of training curriculum and work to deploy necessary program and change management concepts to ensure Quality / STAR results become a way of life and that all constituents have the right tools / resources to track and improve performance.
- Project Management: Lead projects and workgroups to improve Quality / STAR results locally and across the organization. Ensure local leadership alignment and outcomes are consistent with enterprise-wide program goals.
- Performance Tracking and Monitoring: Lead regional meetings provide actionable report/information to local team provides feedback on identify gaps and initiate course corrections to ensure improved results year-over-year. Actively monitor project risks/issues escalate in a timely manner and drive teams to expected performance.
- Audits and Data Integrity Monitoring: Conduct record reviews to identify clinical quality and documentation issues. Submit supplemental data to health plans and monitor encounter/claims/other data reports to maintain data integrity minimize data gaps and implement data collection strategies that optimize data acquisition integration and reporting.
- Team Building: Build strong partnerships with WellBes cross-functional teams including Clinical Operations Analytics/Reporting IT Compliance Coding and Network to develop programs that deliver measurable actionable solutions.
- Other tasks needed to accomplish teams objectives/goals.
Job Requirements
Educational Requirements:
- BS/BA in relevant program or equivalent work experience
- 3-5 years of relevant work within Quality/STARs or any combination of education and experience which would provide an equivalent background.
- Graduate degree preferred
Required Skills and Abilities:
- Strong background/experience with Medicare STARS HEDIS CAHPS HOS programs
- Healthcare experience is required
- Experience in start-up or fast paced dynamic environment
- Ability to multi-task and manage competing priorities
- Demonstrated success managing complex projects or multiple smaller projects encompassing Quality Clinical Operations and other areas impacting Quality/Stars Performance
- Ability to manage large volumes of data analyze data identify data gaps and develop reporting for performance management
- Must be able to work in a matrix environment
- Ability to build strong multidisciplinary cross-functional teams and influence others
- Must have the ability to motivate others prioritize multiple tasks and maintain positive interpersonal working relationships
- Excellent written and verbal communication skills are required. Must be able to communicate effectively with all levels of the organization including ability to present in front of large audience and lead meetings
- Excellent understanding and proficiency with Microsoft Office
Supervisory Responsibility: No supervisory responsibilities.
Travel requirements: Travel may be required up to 10% locally or nationally
Work Conditions: Ability to lift up to 20lbs. Moving lifting or transferring of patients may involve lifting of up to 50lbs as well as assist with weights of more than 100lbs.
- Ability to stand for extended periods
- Ability to drive to patient locations (ie. home hospital SNF etc)
- Fine motor skills
- Visual acuity
Drug Screening Requirement:
As a condition of employment WellBe Senior Medical requires all candidates to successfully complete a pre-employment drug screening. Ongoing employment may also be contingent upon compliance with the companys Drug-Free Workplace Policy which includes random post-accident and reasonable suspicion drug testing. The company reserves the right to test for substances that may impair an employees ability to safely and effectively perform their job duties.
Americans with Disabilities Act:
WellBe Senior Medical is committed to complying with the Americans with Disabilities Act (ADA) and applicable state and local laws. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the job. If you require an accommodation during the application or employment process please contact Human Resources at
The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification. Management reserves the right to add modify change or rescind the work assignments of this position. Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of this role.
Required Experience:
Manager
Employment Type
Full-Time
