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Operations and Compliance Project Manager

1 month ago

Monterey, United States Montage Health Full time
Welcome to Montage Health's application process

Job Description:

The Operations and Compliance Program Manager is primarily accountable for overseeing the implementation, expansion, and fidelity of clinical programs. The ideal candidate will work closely with operational and clinical leaders to ensure regulatory compliance, coordinate operational workflows, define and validate critical metrics for quality, sustainability, outcomes, and cost-effectiveness, and drive the success of our clinical initiatives. This role requires a detail-oriented professional with strong project management skills and a thorough understanding of regulatory requirements in the healthcare industry. This individual will need to understand the strategic objectives of Ohana and Montage Health and assist in the identification and design of key quality and sustainability indicators. The project manager will assist Ohana's leadership team in identifying the right questions to ask in attempting to interpret these indicators and provide support to implement identified changes. This person will have sophisticated analytical skills and excel at working with external vendors, regulators, and other business units within Montage Health.

AREAS OF RESPONSIBILITY

1. Project Management:

a. Conducts feasibility studies and assists with determining cost benefit/ROI for various requested projects.
b. Ensures that project scope, timelines, and budget goals are met, and variances are noted and reported.

c. Manages team expectations, creates and manages internal and external project schedules, and facilitates communication with the Ohana clinical team and other internal and external stakeholders.
2. Program Implementation and Expansion:
a. Lead the planning, execution, and management of clinical program projects from inception to completion.
b. Develop detailed project plans, including timelines, milestones, and resource allocation.
c. Coordinate with cross-functional teams to ensure successful program implementation and scalability.
3. Regulatory Compliance:
a. Work closely with clinical leaders to ensure all clinical programs adhere to relevant regulatory standards and guidelines.
b. Monitor changes in regulatory requirements and update programs accordingly.
c. Conduct regular audits and assessments to verify compliance and implement corrective actions as needed.
4. Operational Workflow Coordination:
a. Streamline and optimize operational workflows to enhance program efficiency and effectiveness.
b. Collaborate with various departments to align operational processes with program goals.
c. Identify areas for improvement and implement best practices to enhance workflow efficiency.
5. Metrics Definition and Validation:
a. Collaborates with clinical and operational leaders, the Technology and Innovation Project Manager, and the Business Intelligence Manager to define and validate critical metrics for quality, sustainability, and cost-effectiveness of clinical programs.
b. Implement measurement systems to track and analyze these metrics.
c. Report on metrics to stakeholders and use data to drive continuous improvement.
6. Quality Care and Clinical Outcomes:
a. Work closely with Clinical and Operational Leaders to maximize the results for Ohana quality initiatives and payor specific quality-based payment programs.
b. Develop and implement strategies to monitor and improve clinical outcomes.
c. Work with clinical teams to address any issues impacting patient care and outcomes.
7. Stakeholder Management:
a. Communicate project status, updates, and risks to stakeholders, including senior management and external partners.
b. Foster strong relationships with internal and external stakeholders to ensure program success.
c. Address and resolve any issues or conflicts that arise during project execution.
d. Work closely with clinical and operational staff and leaders to ensure alignment with goals and objectives.
8. Risk Management:
a. Identify potential risks and develop mitigation strategies to minimize project disruptions.
b. Monitor project progress and adjust plans as necessary to address emerging risks and challenges.
c. Ensure that all project deliverables meet quality standards and regulatory requirements.
9. Documentation and Reporting:
a. Maintain comprehensive project documentation, including plans, reports, and compliance records.
b. Prepare and present regular project status reports to stakeholders.
c. Ensure all project-related documentation is accurate, up-to-date, and accessible.
10. Other Responsibilities:
a. Maintain a working knowledge of billing and coding. Maintain awareness of current events and their effect on the healthcare industry (at the federal, state, and local levels).
b. Recommend, update, and lead the development of application and or process data flow charts and workflow diagrams.
c. Work independently on routine assignments and strive to improve skills & problem-solving abilities.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Strong knowledge and expertise in project management, Project Management Professional (PMP) certification required within 90 days of hire.
2. Highly proficient in Microsoft Office applications, including Word, Excel, PowerPoint, and Visio.
3. Experience in budgeting, coding, business case development, and cost-benefit analyses
4. Proficient organizational, written, verbal, and presentation skills.
5. Experience collaborating between information technology and practice operations.
6. Ability to understand, map, and suggest improvements to clinical workflow processes.
7. Proficient organizational, written, verbal and presentation skills.
8. Knowledge and expertise in Epic, Epic Ambulatory, Epic Cadence, Epic Inpatient preferred.

EDUCATION and/or EXPERIENCE:

1. Bachelor's degree required; master's degree preferred.
2. Three years or more of experience in a healthcare-related or business administration field; understanding of outpatient care, behavioral health care, pediatric care, and/or population health preferred.
3. Three or more years of experience with Project Management.
4. Strong interpersonal skills and ability to communicate across all levels of the organization.
5. Works well independently and collaboratively; is a self-motivator and team-oriented.

Licensure/Certifications:

1. A Project Management Professional (PMP) is required within 90 days of hire.

Equal Opportunity Employer

#LI-CF1

Assigned Work Hours:

Exempt

Position Type:
Regular

Pay Range (based on years of applicable experience):
$62.14
to
$83.07

#HIT