Job description

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Apply here: https://ih.wd1.myworkdayjobs.com/en-US/IHA_Careers/details/Program-Manager---Quality-Strategies_R0008486

Overview

The Program Manager, Quality Strategies is responsible for overseeing the development and execution of strategies, solutions and initiatives to maintain and improve Independent Health’s performance related to quality management including, but not limited to HEDIS, QARR and Star. This role will participate in the development, revision and appraisal of the annual quality improvement work plan. This role will also participate in the planning, development and coordination/facilitation of performance improvement activities within the Population Health Management/Health Care Service departments and across functional areas to assure the integration of quality improvement initiatives in support of the health plan’s achievement of Quality goals. Program timeliness and deliverables are communicated to appropriate parties and are consistently achieved.

The Program Manager will perform rigorous business analysis of plan performance against peer plans and industry benchmarks to identify improvement areas. The program manager will leverage both evidence-based and industry best practices to recommend efficient and effective strategies and solutions to address areas of identified opportunity. The program manager will design and facilitate the development, execution, and measurement of initiatives following improvement science methods. The program manager will work with other team members and organizational staff as assigned and shall function to promote teamwork and accountability in a performance-based work environment.

Qualifications

• Bachelor’s degree required. Masters’ degree preferred. Certified professional in health care quality (CPHQ) or certification in Lean or Six Sigma preferred.

• Five (5) years of experience in healthcare quality data analysis to include two (2) years of project management experience required. Managed care experience strongly preferred.

• Two (2) years of progressive leadership experience/responsibilities required.

• Ability to define problems, collect data and draw valid conclusions. Strong business analytics skills.

• Experience in facilitation preferred.

• Knowledge of emerging technologies, healthcare improvement strategies, and evolving reimbursement mechanisms strongly preferred.

• Solid understanding of at least one of the following preferred: NCQA standards, NYSDOH/CMS regulations and HEDIS measures .

• Experience in developing, implementing and evaluating clinical quality improvement programs required. Solid understanding of improvement science methods (e.g., Lean, Six Sigma, Plan-Do-Study-Act) and quality improvement techniques preferred.

• Demonstrated ability to analyze business data and deliver timely, accurate and relevant reports.

• Working knowledge of campaign management best practices strongly preferred.

• Excellent verbal, written and interpersonal skills required.

• Excellent PC skills required (Word, Excel, Access, PowerPoint). Experience using quantitative analytical tools (e.g., SAS, SPSS) preferred.

• Local travel may be required. Any Independent Health associate who uses a motor vehicle in the course of their duties representing Independent Health must be compliant with New York State Motor Vehicle laws and must follow the Policy that pertains to Driver’s License Requirements as a condition of employment.

• Ability to work a flexible schedule required.

• Demonstrated time management skills, with the ability to work in a self-directed manner.

• Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable.

Essential Accountabilities

• Responsible for contributing to the strategy development, coordination, measurement and ongoing monitoring of quality assurance and performance improvement roadmap initiatives, including annual work plans and evaluations.

• Work collaboratively with stakeholders to identify opportunities for improvement and development of appropriate action plans for problem resolution. Proactively provide best practices in determining the design and implementation of initiatives to achieve goals both member, provider, and delivery system interventions.

• Oversee execution of initiatives using improvement science best practices and work closely with stakeholders on their accountabilities. Accountable for managing critical performance objectives and quality/performance improvement measures per the work plan.

• Analyze and trend quality rates using best practice analytic methods, identify barriers to improvement of rates, and communicate findings to stakeholders through creating interpretive exhibits and storytelling.

• Active participant on the Quality Trend Team, Quality Performance Committee, and HEDIS team. Partake in professional workgroups, quality improvement projects and committees as assigned. Participate in various plan activities, including but not limited to, conferences, health fairs, etc.

• Assure departmental compliance with regulatory and accreditation standards.

• Oversee staff as assigned. Develop, coach and mentor assigned team members.

• Develops appropriate objectives and metrics to measure team productivity. In collaboration with department leadership, identifies opportunities for professional growth and development in order to achieve departmental efforts in support of strategic goals.

• Responsible to develop and implement process improvements to gain/maintain departmental efficiencies.

• Facilitate communication to staff regarding ongoing corporate initiatives by representing the department in cross-functional meetings and assist in the decision-making process to ensure that the needs of the department are being met.

• Manage within financial budget.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Professional development assistance
• Tuition reimbursement
• Vision insurance

Schedule:

• Monday to Friday

COVID-19 considerations:
New hires must be fully vaccinated against the COVID-19 virus by the date of hire, unless granted an accommodation for a qualified medical or religious vaccine exemption

Education:

• Bachelor's (Preferred)

Experience:

• healthcare quality data analysis: 5 years (Preferred)
• progressive leadership: 2 years (Preferred)
• project management: 2 years (Preferred)

Work Location: One location

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