Healthfirst Program Manager for Quality Initiatives and Special Projects in New York, New York

Description

The Program Manager for Quality Initiatives and Special Projects is an integral role that serves as a point of contact within DSE for Quality Initiatives and Special projects assigned to DSE for coordination and /or implementation. The Program Manager will oversee quality initiatives within the provider network that contribute to ensuring that Healthfirst continues to maintain excellence in quality [ i.e. Access and Availability, CAHPS – Access to Care] (2) ensures that regulatory and compliance deliverables are strategically managed and meet necessary deadlines (i.e. IPRO/Directory audits). In this role, the Program Manager will coordinate and draft responses and make recommendations on how to ensure the department can avoid future external risks. Additionally, The Lead will also oversee/manage special projects within the department as assigned [i.e. hospital terminations, implementation of benefit carve ins].

Duties/Responsibilities:

  • Serves as a Point of Contact on assigned quality initiatives and special projects

  • Helps to manage overall strategy to address Quality Initiatives and Special Projects

  • Makes recommendations on strategy and process improvement to drive successful outcomes for quality, initiatives as well as special projects assigned.

  • Monitors various Correct Action Plans within the department to ensure action items are successfully met

  • Coordinates and tracks off boarding efforts in hospital terminations and closures

  • Tracks all projects/initiatives and creates reporting mechanisms that can be shared with management

  • Creates presentations and presents on initiatives as needed

  • Works with internal business partners as needed to ensure successful rollout /completion of assigned initiatives/projects/deliverables (Regulatory, Product, Marketing, Compliance, Clinical Partnership, Population Health, Clinical Quality, etc)

  • Takes the lead and coordinating draft provider communications to ensure proper role out of initiatives to provider community; Works with marketing to facilitate, create and roll out talking points/FAQs as needed

  • Serves as an SME within DSE for initiatives assigned within DSE core areas (Hospital, Community, Ancillary, Behavioral Health, Vendor Management) that require additional support

  • Attend meetings/committees as needed

  • Develops and trains staff as needed on key initiatives

  • Additional duties as assigned.

Minimum Qualifications:

  • Experience managing a team responsible for high-level servicing and educating providers and/or their staff on managed care contracts, procedures, reimbursements, credentialing, etc.

  • Valid driver's license and insured automobile

  • Personal qualities: Customer service minded, mission-driven, proactive, critical thinking mindset

  • An entrepreneurial spirit that looks to the best interests of the plan and its providers by bridging and creating common interests to develop meaningful provider partnerships and experiences for our members

  • Managers must have qualities that will encourage and foster a high-performance team such as good listening and communication skills

  • Ability to demonstrate leadership traits that reflect empowerment of staff decision making with demonstrated team oversight

  • Contract negotiation experience Policy and Job Aid writing

  • Adept at working in an environment with fast-past changing priorities while achieving departmental goals and objectives

  • Ability to represent the company at provider functions

  • Ability to work occasional overtime required.

  • Excellent written communication and the ability to document grammatically correct notes/correspondence

  • Professional Writing skills (Letter writing, Memo and Email)

  • Understanding of and sensitivity to cultural differences and needs of the community are essential

  • Experience managing provider information in a shared network environment using paperless database modules and archival systems

  • Ability to communicate on an individual basis as well as in a group setting

  • Ability to motivate others

Preferred Qualifications:

  • Bachelor's degree or higher from an accredited institution

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law, and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

EEO Law Poster and Supplement

REQNUMBER: R003167