Program Manager - Quality Improvement, South San Francisco, CA
Program Manager- Quality Improvement
The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Program Manager that will be responsible for program development, integration and execution in support of departmental processes, operations and administrative efficiency for the Quality Improvement Department. The immediate primary responsibility of the Program Manager is to lead the regulatory survey readiness program planning to support the organization’s business objectives toward National Committee for Quality Assurance (NCQA) accreditation.
The essential duties and responsibilities will include the following:
- Works independently across all departments to ensure the NCQA survey readiness and planning. Develops work plans, gap analysis, survey readiness, and stakeholder collaboration for upcoming survey. Acts as the primary liaison with the executive team, staff, and consultants for both initial and continuous NCQA survey readiness.
- Leads all aspects of NCQA accreditation including application, surveys and file reviews.
- Develop an organized system to assess, collect, and document each department’s level of compliance with applicable standards;
- Actively prepare and participate in on-site surveys, including coordination of agendas, assigning tasks, tracking activities, and communication plans for internal and external stakeholders.
- Facilitate mock surveys/audits and develop plans for improvement.
- Participate in the development of corrective action plans, monitoring plan, and closure within defined timeframes.
- Lead departmental and organizational meetings for survey readiness.
- Educates and trains health plan staff regarding accreditation standards and their respective
responsibilities in carrying out the accreditation project , including but not limited to:
- Developing presentations and effectively communicating survey readiness information to all levels of the organization;
- Developing internal and external communication related to accreditation and regulation information;
- Developing templates, tools, and processes to facilitate an efficient and effective means for regulatory compliance;
- Collaborating with internal and external stakeholders to proactively identify and define areas for improvement for survey readiness activities.
- Manage program(s) from initiation through delivery and monitor for continuous improvement.
- Provide input into designing strategies for alignment with functional unit goals and objectives.
- Develop methods, techniques and evaluation criterion for obtaining results.
- Plan, execute and evaluate program initiatives to improve performance.
- Participate cross-functionally in business planning to support business unit strategy.
- Contribute to project teams, assigning and monitoring work of team members and providing guidance and leadership.
- Act as the business unit liaison to corporate initiatives and projects.
- Educate and work with external partners and participating practices as needed to identify innovation opportunities and adopt improvement actions.
Education and Experience: Bachelor’s Degree in Business Administration, Health Care Management or Public Policy required. MBA, MPH or MPP preferred. Minimum three (3) years of managed care experience preferably with Medicare/Medi-Cal experience. Experience with quality improvement/process improvement techniques required. Previous project/program management experience required. Experience leading or assisting in leading NCQA accreditation highly preferred. Experience in leading Joint Commission or URAC certification preferred.
Knowledge of: NCQA standards and processes (preferred). Relationship Building and Interpersonal Skills. Financial/Quantitative Acumen. Change management, process improvement and redesign. Organizational behavior skills with a focus on driving for results. Project management, program evaluation and consulting skills. Knowledge of accrediting/regulatory body requirements. Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access and PowerPoint.
Ability to: Work cooperatively with others. Work as part of a team and support team decisions. Communicate effectively, both verbally and in writing. Adapt to changes in requirements/priorities for daily and specialized tasks. Think critically and make informed decisions.
Starting Compensation Range: $81, 208- $105,570/annually - depending on experience
Benefits Information: Excellent benefits package offered, including HPSM paid premiums for employee’s coverage in the medical HMO plan and majority of PPO medical cost. Employee pays a small portion of the dependent premiums for medical and dental benefits. Additional HPSM benefits include fully paid vision, life, AD&D, STD, and LTD insurance; retirement plan (10% of salary for compensation/HPSM paid); holiday and vacation pay; tuition reimbursement plan; and more.
Application Process: To apply, submit a resume and cover letter with salary expectations to: Health Plan of San Mateo, Human Resources Department, 801 Gateway Blvd., Suite 100, South San Francisco, CA 94080 or via email: firstname.lastname@example.org or via fax: (650) 616-8039. File by: Continuous until filled. EOE