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Company

Medical Mutual · 8 hours ago

Health Plan Quality Program Manager

Ohio, United States

Full-time

Remote

Mid, Senior Level

3+ years exp

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Responsibilities

Facilitates projects to increase Star Ratings involving one or more cross-functional teams through execution and implementation, monitoring project performance and improvements.

Manages overall Stars initiative project plan for the parent and subsidiary Companies government programs contracts.

Collaborates with appropriate stakeholders to ensure timely project delivery, anticipates risks, and plans accordingly.

Leverages Star measures analytics and industry insights to identify opportunities to improve Star Ratings.

Collaborates and builds relationships throughout the organization to manage expectations and drive customer satisfaction, while educating and promoting a culture of continuous improvement.

Performs other duties as assigned.

Leads and/or participates in cross-functional, enterprise-wide teams to improve Star Ratings performance. Formulates detailed project plans that are agile and targeted to meet multiple goals and objectives within timeline. Assures collaboration with internal departments and/or external contacts. Anticipates risks and plans accordingly. Manages the change process with minimal impact to the business.

Manages overall Stars initiative project plan for the parent and subsidiary Companies government programs contracts.

Leverages Star measures analytics and industry insights to identify opportunities to improve Star Ratings and drive the evaluation of initiatives.

Collaborates and builds relationships throughout the organization to manage expectations and drive customer satisfaction, while educating and promoting a culture of continuous improvement.

Maintains and shares knowledge of regulatory requirements and industry best practices.Attends training sessions and other appropriate industry meetings. Orients, trains, and assists more junior level staff.

Performs other duties as assigned.

Qualification

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Process ImprovementLean Six SigmaProject ManagementData InterpretationMicrosoft OfficeTableauHealthcare AdministrationMedicare ExperienceMedicaid Experience

Required

Bachelor's degree in business or healthcare administration or related field or equivalent combination of education/training and experience.

3 to 5 years progressive experience leading medium to large projects and enterprise-wide process or technology implementations, preferably in health care.

Knowledge of process improvement and/or lean six sigma methodologies.

Intermediate to advanced Microsoft Office and database reporting skills.

Proficiency with Tableau or similar reporting tools.

Strong facilitation and project management skills.

Excellent oral, written, interpersonal and presentation communication skills with the ability to communicate with stakeholders at various levels of the organization.

Ability to interpret data trends and patterns, applying them to business processes.

Ability to read and interpret government regulations and apply to Company operations.

5-7 years of experience as a Health Plan Quality Program Manager or equivalent progressive experience leading projects and enterprise-wide process or technology implementations, preferably in health care.

Preferred

Experience in Medicare and/or Medicaid preferred.

Project Management certification preferred.

Project Management certification strongly preferred.

Strong knowledge of process improvement and/or lean six sigma methodologies.

Advanced Microsoft Office and database reporting skills.

Benefits

Employee bonus program.

401(k) with company match up to 4% and an additional company contribution.

Health Savings Account with a company matching contribution.

Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority.

Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.

Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.

After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

Career development programs and classes.

Mentoring and coaching to help you advance in your career.

Tuition reimbursement up to $5,250 per year, the IRS maximum.