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WellCare of Kentucky · 11 hours ago

Clinical Program Manager

United States

Full-time

Remote

Mid, Senior Level

$88K/yr - $158K/yr

5+ years exp

WellCare of Kentucky is a diversified national organization seeking a Clinical Program Manager to manage and track clinical projects that align with the strategic plan. The role involves working closely with the Regional Medical Director to analyze data and implement key interventions aimed at improving member experience, quality of care, and reducing healthcare costs.

Health CareMedical

Responsibilities

Responsible for managing and tracking clinical projects that advance the objectives of strategic plan with key provider groups and/or hospital systems by supporting established committees and creating new work teams; including such activities as organizing and publishing agendas, documenting minutes, maintaining work plans and monitoring open action items

Works closely with the Regional Medical Director to analyze data and develop and implement key interventions to support the Triple Aim, including developing work plans, workflows, policies and procedures, and serving as workgroup leader when appropriate in order to execute initiatives

Serves as project leader for cross functional initiatives that are intended to drive performance improvement engaging across functional teams as needed to ensure effective communication of project requirements, as well as tracks progress of action plans

Facilitates the development of clinical reports and the delivery of data to key provider partners; as well as develops internal reports to demonstrate progress

Performs detailed analysis of data, workflows, policies, procedures and organization of staff, in order to execute initiatives

May use project management software to support initiatives

Performs other duties as assigned

Complies with all policies and standards

Qualification

Project ManagementMicrosoftPowerBiGoogle SmartSheetsMedicaidCase ManagementData AnalysisLean BeltPresentation Skills

Required

Bachelor's Degree in Nursing, International Medical Graduate, Master's Degree in Public Health (MPH), Hospital Administration (MHA) or Business Administration (MBA) or equivalent experience

Five to seven years managed care, hospital or medical group experience, focusing on quality improvement, utilization management, or clinical operations

Experience analyzing and presenting data to drive outcomes

Experience making presentations in group settings

At least two years project management experience of managing a project at any level at a medical group, IPA or health plan setting

Project Management Experience Needed

Technology Heavy Microsoft, PowerBi, Google SmartSheets

Knowledge of Medicaid

Case management knowledge