Healthcare Transformation Manager
2 weeks ago
Job Summary:
The Manager, Provider Practice Transformation is a key role within the Santa Clara Family Health Plan (SCFHP) organization, responsible for leading the Provider Network Operations team in delivering high-quality care to our members. This position requires a strong understanding of healthcare operations, quality improvement, and practice transformation.
Key Responsibilities:
- Develop and implement strategies to improve network performance, including communication, outreach, implementation, training, education, service, measurement, and reporting of quality improvement and practice transformation initiatives.
- Collaborate with SCFHP's Quality Improvement, Health Equity, and Risk Adjustment teams to further PPP and practice transformation initiatives.
- Develop and maintain trusting relationships with providers, staff, and leadership of contracted health plans, physicians, hospitals, ancillary providers, and IPAs to drive innovation and continuous quality improvement.
- Manage the planning, execution, and evaluation of QIHEP initiatives, HEDIS, and practice transformation provider projects from initiation/pilot phase through project closure to improve quality performance, SCFHP's HEDIS scores, and other quality metrics.
- Establish metrics to monitor ongoing results and communicate clearly and concisely with providers at all levels, including administration, the provider office staff, and relevant vendors.
Requirements:
- Bachelor's Degree in Business, Healthcare Administration, or a related field, or equivalent experience, training, or coursework.
- Minimum six years of experience in a healthcare, clinical, or managed care setting, provider organization, or health policy organization requiring routine interaction with internal and external stakeholders and program management responsibilities.
- Demonstrated achievement and progressive responsibilities in the area of provider network management.
- Minimum three years direct supervisory/management experience.
- Ability to establish and maintain effective internal and external working relationships to organize and lead cross-functional teams.
Working Conditions:
Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications.
Physical Requirements:
Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation.
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