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Medical Management Initiative Specialist
1 month ago
AmeriHealth Caritas is seeking a highly skilled Medical Management Initiative Specialist to provide consultation, technical assistance, and program management support in the areas of health promotion/pay for performance or contract mandated quality or health promotion programs.
The ideal candidate will lead programmatic development, implementation, optimization, analysis, and documentation of programmatic results. This role will manage and coordinate programs and activities associated with the department's quality or health promotion goals, creating program status reports, drafting work plans and timelines, and coordinating other project management functions.
The Medical Management Initiative Specialist will work in consultation with appropriate market, product, and enterprise leadership in strategic direction and planning of program initiatives, facilitating programs through workplan development and identification and communication with internal and external stakeholders.
This role requires collaboration with internal and external stakeholders, managing all levels of relationships, maintaining and analyzing program data for trends and accuracy, and fostering further strategic and/or operational improvements.
The successful candidate will design and develop innovative programs to support quality and health promotions goals in collaboration with clinical, quality, and business leadership at the local market and enterprise population health organizations, working in alignment with the overall business goals and objectives; including HEDIS, NCQA, and specific product/market goals.
Responsibilities:
Provide consultation, technical assistance, and program management support in the areas of health promotion/pay for performance or contract mandated quality or health promotion programs.
Lead programmatic development, implementation, optimization, analysis, and documentation of programmatic results.
Manage and coordinate programs and activities associated with the department's quality or health promotion goals.
Create program status reports, drafting work plans and timelines, and coordinating other project management functions.
Work in consultation with appropriate market, product, and enterprise leadership in strategic direction and planning of program initiatives.
Facilitate programs through workplan development and identification and communication with internal and external stakeholders.
Collaborate with internal and external stakeholders, managing all levels of relationships.
Maintain and analyze program data for trends and accuracy, and foster further strategic and/or operational improvements.
Requirements:
Bachelor's Degree.
Quality Improvement or project management experience (certification preferred).
Performance improvement training (LEAN, Six Sigma, IHI etc.).
3+ years of experience in similar function or related field with level of accountability commensurate with responsibilities described. Proven skills in analyzing reported data to collect relevant statistics.
Experience in quality or health promotion initiative development and monitoring.
Strong collaboration and communication skills including leading cross-disciplinary teams.
Data & analysis skills.
Proficiency with productivity tools to include Microsoft Word, PowerPoint, Excel, Teams, and Visio.
Medicaid managed care experience preferred.
AmeriHealth Caritas:
AmeriHealth Caritas is a mission-driven organization with over 30 years of experience delivering comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management, and specialty pharmacy services, behavioral health services, and other administrative services. We are passionate about helping people get care, stay well, and build healthy communities.
