Project Manager, Quality Improvement

10 hours ago

Huntington Beach, United States Clever Care Health Plan Full time $70,000 - $90,000
Job Details

Job Location

Huntington Beach Office - Huntington Beach, CA

Position Type

Full Time

Description

Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California’s fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth.

Who Are We?

Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members’ culture and values.

Why Join Us?

We’re on a mission Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you’ll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation.

Job Summary

The Project Manager is responsible for the management of highly visible, sensitive, and multi-faceted projects. Oversee multiple tactical and strategic projects from initiation through closing under limited supervision as directed by Quality Improvement Leads. Projects assigned are broad in scope and may involve multiple functional areas. Position will exercise judgement within generally defined practices/policies in selecting appropriate methods and techniques for obtaining favorable results. Ensures projects are delivered within scope, schedule, budget, and quality levels meeting or exceeding expectations.

Functions & Job Responsibilities

  • Manage Quality initiatives and projects.
  • Collaborate on the development and management of Stars Program monthly performance dashboards to manage program performance and projections
  • Develop incentive report cards (bonus potential, current performance, opportunity). Would include development of annual payout calculations across incentivized measures (HEDIS, STARS, HOS, Pharmacy, and CAHPS)
  • Partner with Data Analyst to serve as an internal analytic consultant to define business questions and transform data and analysis into meaningful and actionable information
  • Develop annual off –cycle CAHPS survey to support future state CAHPS incentives across provider contracts, including payout of incentives for achieved CAHPS targets
  • Creating a consistent tracking process and reporting cadence
  • Monitor for at-risk initiatives to allow the Quality team to be on track with goals
  • Mentor, coach and provide direction to team members in collaboration with department leadership to ensure goals, expectations and objectives are met.
  • Engage with Quality leadership to capture information to set, develop, monitor and track Quality Initiatives in the Annual Quality Workplan
  • Facilitate information and tracking meetings to ensure regular monitoring of team progress.
  • Manages all aspects of assigned projects throughout the project lifecycle.
  • Develop and maintain detailed work plans to include milestones, tasks, dependencies, and target dates of completion.
  • Schedule and facilitate regular project status meetings to include logistics, agendas, and meeting minutes.
  • Active participant in strategy development, as well as writing, communicating, facilitating, and presenting cogently to and/or for all levels of internal staff i.e., presentation slides, Quality tools, policies and procedures, workflow documents and other standard business communications.
  • Develop framework and workflows of operational processes within the business unit.
  • Regularly perform gap analysis in current workflows and identify actionable steps for process improvement and/or enhancements.
  • Monitors and controls all aspects of the project by measuring progress and correcting course when project goes beyond scope or is not meeting goals and objectives.
  • Ensures project remains on timeline by consistent monitoring and reporting of progress
  • Manage project risk by identifying, planning for, developing, and implementing strategies to mitigate or minimize risk, and monitor findings, throughout the project. Appropriately escalate risks and/or issues to management as needed.
  • Maintain positive relationships within Clever Care business units and promote collaboration and exchange of information across business units.
  • Exercise creativity and flexibility by determining the appropriate combination of knowledge, skills, tools, and techniques for an assigned project.
  • Actively participate, or may lead, in analyzing data and developing recommendations and action plans.
  • Accountable for the development of project documentation for management and other key stakeholders to facilitate sharing of lessons learned and best practices.
  • Plan and facilitate meetings as assigned.
  • Facilitate conflict resolution within project team.
  • Other duties as assigned.

Leadership Expectations

By way of leadership approach, mobilize others to create extraordinary results, and unite people to turn challenges into successes by championing the following:

  • Model the Way:
  • Clarify values by finding your voice and affirming shared values
  • Set the example by aligning actions with shared values
  • Inspire a Shared Vision
  • Envision the future by imagining and sharing exciting possibilities
  • Enlist others in a common vision by appealing to shared ambitions
  • Challenge the Process
  • Search for opportunities by seizing the initiative and looking outward for innovative ways to improve
  • Experiment and take risks by consistently generating small wins and learning from experience
  • Enable Others to Act
  • Foster collaboration by building trust and facilitating relationships
  • Strengthen others by increasing self-determination and developing competence
  • Encourage the Heart
  • Vendor oversight and management for Quality related initiatives/projects
  • Oversight and Management of events such as Health fairs, Member Appreciation Events and other QI related events
  • Celebrate the values and victories by creating a spirit of community

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Qualifications

Qualifications

Education and Experience:

  • Bachelor’s degree in business administration or in a directly related field
  • Three (3) to five (5) years of project management experience
  • Project management experience in health care preferred
  • Sales experience in health care preferred

Skills:

  • Familiarity with project management tools and platforms e.g., Jira, MS Project
  • Proficiency in Windows, including MS Outlook, MS Word, Excel, and PowerPoint
  • Strong organizational and analytical skills
  • Exceptional listening, problem-solving, and verbal and written communication skills
  • Respect for and desire to learn from other cultures
  • Effective interpersonal skills

Salary Range: $70,000.00/yr - $90,000.00/yr

Physical & Working Environment.

Physical requirements needed to perform the essential functions of the job, with or without reasonable accommodation:

  • Must be able to travel when needed or required
  • Ability to operate a keyboard, mouse, phone and perform repetitive motion (keyboard); writing (note-taking)
  • Ability to sit for long periods; stand, sit, reach, bend, lift up to fifteen (15) lbs.

Ability to express or exchange ideas to impart information to the public and to convey detailed instructions to staff accurately and quickly.

Work is performed in an office environment and/or remotely. The job involves frequent contact with staff and public. May occasionally be required to work irregular hours based on the needs of the business.

Disclaimer

The above information on this description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job.

Clever Care Health Plan is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.

Salary ranges posted on the job posting are based on California wages. Salary may be higher or lower depending on the candidate’s state residency.

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