Who we are

Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.

Our commitment is to:

• Strive to apply an equity lens to all our work.
• Reduce health disparities.
• Become an anti-racist organization.
• Create an equitable work environment.

About the Role

The Program Manager of Quality Performance is responsible for creation, maintenance, monitoring, and oversight of systems and processes related to the accreditation process and state and federal quality regulatory requirements; serves as Subject Matter Expert (SME) for document management, document processes, and standard document submissions; creates project management plans, writes necessary reports, ensures compliance on deliverables by business owners, and produces performance dashboards.

To be successful in this role, you:

• Possess a bachelor’s degree in a related field, or an equivalent combination of education and highly relevant experience required.
• Possess professional Project Management Professional (PMP) certification (preferred).
• Have a minimum of two (2) years in a health or managed care setting involving work related to regulatory compliance and healthcare accreditation required. Relevant education beyond bachelors’ degree may count toward experience.
• Have a minimum of three (3) years project management experience driving organization-wide initiatives (preferred).

Essential functions and Roles and Responsibilities:

• Accreditation and Regulatory Readiness: Ensure compliance with NCQA accreditation standards and regulatory requirements by reviewing and incorporating requirements into project plans and acting as subject matter expert and accreditation resource to internal business owners.
• Project Planning: Drives improvement initiatives throughout Quality Department specific to NCQA accreditation and additional regulatory requirements.
• Quality and Performance Review: Works with Quality Directors and Manager of Quality Performance to provide support and lend expertise to Quality Improvement committees.
• Quality Program Documents: Manages Quality Program documents, including quarterly tracking, annual revisions, and compiling reports.
• Represents Community Health Plan of Washington in Federal, Regional and State activities or visits for the purpose of regulatory audits or accreditation reviews.
• Exempt – Employees are expected to report to work as scheduled, participate in all assigned meetings, and meet established performance and accountability standards.
• Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion.

Knowledge, Skills, and Abilities:

• Understanding and ability to interpret accreditation and federal and state health plan regulatory standards, particularly related to NCQA health plan accreditation.
• Advanced MS Office skills, including MS Project, PowerPoint, Excel, Access.
• Experience managing change initiative for health care teams.
• Strong process improvement skills.
• Ability to present complex data and compile meaningful reports.
• Demonstrated relationship-building skills.
• Previous experience executing change management strategies/recommendations in a team environment.
• Excellent oral and written communication skills.
• Ability to multi-task competing priorities on a regular basis

Note: If you think you do not qualify, please reconsider. Studies have shown that women and people of color are less likely to apply to jobs unless they feel they meet every qualification. However, everyone brings different strengths to the table for a job, and people can be successful in a role in a variety of ways. If you are excited about this job but your experience doesn’t perfectly check every box in the job description, we encourage you to apply anyway.

As part of our hiring process, the following criteria must be met:

• Complete and successfully pass a criminal background check.

Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant’s criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees.

• Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency.
• Vaccination requirement (CHPW offers a process for medical or religious exemptions)
• Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation.

Compensation and Benefits:

The position is FLSA Exempt and is not eligible for overtime and has a 10% annual incentive target based on company, department, and individual performance goals. The base pay actually offered will take into account internal equity and also may vary depending on the candidate’s job-related knowledge, skills, and experience among other factors.

CHPW offers the following benefits for Full and Part-time employees and their dependents:

• Medical, Prescription, Dental, and Vision
• Telehealth app
• Flexible Spending Accounts, Health Savings Accounts
• Basic Life AD&D, Short and Long-Term Disability
• Voluntary Life, Critical Care, and Long-Term Care Insurance
• 401(k) Retirement and generous employer match
• Employee Assistance Program and Mental Fitness app
• Financial Coaching, Identity Theft Protection
• Time off including PTO accrual starting at 17 days per year.
• 40 hours Community Service volunteer time
• 10 standard holidays, 2 floating holidays
• Compassion time off, jury duty

Sensory/Physical/Mental Requirements:

Sensory* :

• Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance.

Physical* :

• Extended periods of sitting, computer use, talking and possibly standing
• Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion
• Frequent torso/back static position; occasional stooping, bending, and twisting.
• Some kneeling, pushing, pulling, lifting, and carrying (not over 25 pounds), twisting, and reaching.

Mental :

• Must have the ability to learn and prioritize multiple tasks within the scope and guidelines of the position and its applicable licensure requirements, many requiring extremely complex cognitive capabilities. Must be able to manage conflict, communicate effectively and meet time-sensitive deadlines.

Work Environment:

Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation.