Special Programs Manager II - Quality Systems

Date: Sep 3, 2021

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 5338 

 

Position Summary/Position

 

Under the direction of the Senior Director of Quality Systems, the Special Programs Manager II - Quality Systems supports the Quality Systems department in the coordination of intra and interdepartmental system configuration and process projects in the areas of HEDIS, Pay for Performance, Risk Adjustment, Quality Improvement activities, Provider risk profiles, Member and Provider surveys, data aggregation, data collection, vendor oversight, and reporting. The Special Programs Manager II - Quality Systems is responsible for programs management including initiation, planning, development and monitoring of Special Programs implementations in order to ensure on time accuracy and fiscal sustainability.

This position will act as a liaison between several functional departments for related activities to ensure projects and issues are tracked, updated, and reported out frequently as scheduled. This position will also provide support to department Managers and Directors to coordinate the delivery of documents related to internal and external audits for the Core Business Systems department (NCQA, Medicare Readiness, DHCS Compliance Review, etc.) This will position will ensure that policies and procedures, requirements, change control requests, and issue management tickets are completed as necessary and available for review. This position will provide expertise and knowledge to project management processes for release management, and interdepartmental issue response and resolution management (issues and projects assigned for the Level II position of Special Programs Managers will generally be medium‐to-high priority / size of complexity). This position will be involved with technology deployments and communications of project and issue management at the Manager, Director, and Chief levels.

Major Functions (Duties and Responsibilities)

 

1. Provide research, analytical support, and project management to the Senior Director of Quality Systems, Director of Quality Informatics, and Director of Quality Management in the areas of issue resolution, implementation of regulatory changes, strategic projects, and configuration and processes that are in the best interest of Quality Systems business operations

2. Manage medium‐to‐large complexity / medium‐to‐high priority projects and issues inclusive of business, regulatory, or technology deployments (inclusive of project budgets and acquiring resources with agreements from functional areas, 3rd party vendors, and consultants)

3. Coordinate, prepare, and monitor assigned Quality Systems department projects, documentation and report outs. Capture process efficiencies developed through projects and incorporate LEAN methodologies into project practices

4. Act as a liaison between several functional departments for configuration and software‐related activities to ensure projects and issues are tracked, updated, and reported out frequently as scheduled.

5. Assist the Directors of Quality Systems to work with external vendor(s) if needed in planning and implementing specific initiatives, and to manage the terms of the vendor service agreement. Assist the Directors of Quality Systems in the collaboration with Quality Systems departments and Compliance in planning, developing, and submitting responses to audits. Support the Directors of Quality Systems to operate the various Quality Committees, ensuring all follow‐up activities or action items from the meetings are completed in a timely manner. Support the Sr. Director of Quality Systems and Chief sponsors on special companywide and departmental projects and initiatives

6. Monitor ongoing work plans and initiatives to ensure that interventions are completed to mitigate risks and issues

7. Assist in coordination of annual reviews of Policies and Procedures (PnP) which includes gap analysis for PnPs, working with SMEs to update existing content or creating new documents, and uploading into Compliance 360, SharePoint, or other source document management areas as needed. Assist in the responses and completion of deliverables to Corrective Action Plans (CAPs).

8. Determine program resource requirements and procedure resources.

9. Gather details for budgets needed and analysis for special projects or issue resolution as requested by the Directors of Quality Systems for Quality Systems departments.

10. When required, leads or assists with the development of Request for Proposals (RFP) for external products and / or services.

Supervisory Responsibilities

Leading: Guides Others

Experience Qualifications

 

5 years of experience in program and project management. Application experience and knowledge of standard PM practices with ability to develop plans.

Education Qualifications

 

Master’s degree from an accredited institution OR Certification listed below is required.

Professional Certification

 

PMP, PgMP, CBAP or PMI‐PBA;  OR Master’s Degree from an accredited institution.

Drivers License Required

Yes, must have a valid California Driver's License.

Knowledge Requirement

 

Must possess strong knowledge of project management and cross‐ organization coordination. Understanding and sensitivity to a multi‐cultural environment and community. This position provides key operational information and key organizational tactical / strategic information through the effective implementation of data initiatives.  Initiatives include data trending analyses, data profiling, data mining, data analysis, and promoting a data‐aware culture throughout IEHP.

Skills Requirement

 

Strong interpersonal skills. Strong project management skills and strong issue management skills. Microcomputer applications: spreadsheet, database, and word processing. Must have excellent writing, interpersonal communication, and organizational skills.

Abilities Requirement

 

Strategic thinker. Must support a culture of collaboration. Strong ability to translate data into meaningful and actionable information. A high degree of patience, attention to detail and the ability to work in changing, fast‐paced environment.

Commitment to Team Culture

 

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions

 

Word processing involving computer keyboard and screens; travel within California.

 

Starting Salary: $75,296.00  - $95,992.00  

Pay rate will commensurate with experience

 

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region. With a provider network of more than 6,000 and a team of more than 2,000 employees, IEHP provides quality, accessible healthcare services to more than 1.2 million members. And our mission and core values help guide us in the development of innovative programs and the creation of an award winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and Make a Difference with us! IEHP offers a Competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and retirement plan.

 


Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles