Program Manager, Quality Improvement (HEDIS)

Job Description

JOB DESCRIPTION

Job Summary

Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project/program management.

The ideal candidate for this role will be proficient with Excel and have an understanding of HEDIS, Quality Improvement and / or Risk Adjustment.

Job Duties

• Active collaborator with people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion.
• Plans and directs schedules as well as project budgets.
• Monitors the project from inception through delivery.
• May engage and oversee the work of external vendors.
• Focuses on process improvement, organizational change management, program management and other processes relative to the business.
• Leads and manages team in planning and executing business programs.
• Serves as the subject matter expert in the functional area and leads programs to meet critical needs.
• Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements. Delivers the appropriate artifacts as needed.
• Works with operational leaders within the business to provide recommendations on opportunities for process improvements.
• Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.
• Generate and distribute standard reports on schedule
• Proven experience in quality improvement initiatives, particularly related to HEDIS measures and managed care quality performance outcomes
• Strong background in driving managed care quality improvement through data analysis, process optimization, and cross-functional collaboration to enhance patient outcomes and operational efficiency.

JOB QUALIFICATIONS

REQUIRED EDUCATION :

Bachelor's Degree or equivalent combination of education and experience.

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :

• 3-5 years of Program and/or Project management experience.
• Operational Process Improvement experience.
• Healthcare experience.
• Experience with Microsoft Project and Visio.
• Excellent presentation and communication skills.
• Experience partnering with different levels of leadership across the organization.

PREFERRED EDUCATION :

Graduate Degree or equivalent combination of education and experience.

PREFERRED EXPERIENCE :