Plans, monitors, and manages internal projects from initiation through timely completion to meet business objectives and increase performance
Oversees all aspects of quality project implementation including budget development and supervision of team participants
Prioritizes and makes recommendations for the design, development, and implementation strategy of quality improvement projects and initiatives
Designs the data collection methodology, metrics, and data elements needed to measure outcomes of QI projects
Develops documentation templates and systems to support QM projects and initiatives
Updates and monitors multiple workplans for timely and accurate State submission
Forms and leads cross functional workgroups to design and implement QI initiatives
Translates and delivers business information to internal and external constituents via formal presentations with data visualization tools and/or written communications
Creates a continuous improvement plan for the project to enhance delivery processes and outcomes
Drives performance to meet established goals (e.g., CAHPS and other member satisfaction surveys, Lead Screening activities, Community Focused Care Accreditation)
Oversees clinical documentation audits (e.g., Community-Based Palliative Care and Managed Long Term Supports and Services HEDIS hybrid project)
Educates and consults with unit business managers on quality improvement methods (e.g., workflow, data analysis, metrics)
Educates members and providers on relative QI initiatives to increase clinical performance
Mentors internal QM staff regarding quality related programs, workplans and evaluation activities
Actively seeks opportunities for process improvement resulting in efficient and effective work streams
Manages complex relationships with both internal and external constituents
Requirements
7-10 years of relevant managed care experience
5 to 7 years quality and/or care management experience
Exceptional verbal/written/presentation communication skills
Ability to analyze and manage large amounts of data
Demonstrated ability to plan, organize, and execute multiple projects with overlapping deliverables
Proficient in workplace applications and collaboration tools (e.g., Microsoft 365, cloud-based document management, virtual communication/collaboration, and project platforms)
Attention to detail, accuracy and overall quality of reports
Adept at problem solving and decision-making skills
Strong collaboration and teamwork skills
Strong organizational skills
Motivational interviewing skills and positive attitude
Self-motivated and leadership qualities
Project Management Certification (preferred)
NJ residence (preferred)
Master’s degree (preferred)
Tech Stack
Cloud
Benefits
Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs