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The Quality Improvement Project Manager II is a healthcare project specialist who is responsible for managing day-to-day operations of a portfolio of projects, and providing support for ongoing special projects within L.A. Care's Quality Improvement Department. In this role, the Project Manager is responsible for ensuring program activities are completed in a high quality and timely manner and ensuring compliance with all regulatory guidelines such as Medicaid (Medi-Cal), Medicare, Health Exchange, and Healthy Kids as well as National Committee for Quality Assurance (NCQA) Accreditation.
Job Responsibility
Design and management of a portfolio of assigned projects within budget to: Ensure that projects are delivered timely, accurately and in compliance with all regulatory requirements and NCQA Standards and within other established metrics
Present quarterly quantitative and qualitative performance analysis and reports to Quality Oversight Committees as well as other committees
Monitor the performance of current service interventions as well as coordinate new interventions
Process analysis, process evaluation and assist in implementing process improvements to: Ensure Business Process Improvement meets requirements and expected business benefits
Develop appropriate project management tools to develop, implement and evaluate current projects
At least annually, assess projects to determine if they are meeting performance goals and provide project plan for continuous quality improvement
Identify, recommend and apply business solutions, derived from findings of research and analysis
Gain departmental efficiencies
Documentation of existing business processes and industry best practices by: Workflows of existing processes and interdependencies
Complete and accurate work plans for all assigned projects
Complete business requirements for analytical tools used to measure project improvement
Lead vendor selection processes, implement and manage vendor contracts by: A successful selection of vendors with positive Return of Investment (ROI) analysis
Comply with Request for Proposal (RFP) process for vendors every three years, followed by Request for Quotation (RFQ) in interim years
Documentation must be in compliance with company protocol
Perform other duties as assigned
Requirements
Bachelor's Degree
In lieu of degree, equivalent education and/or experience may be considered
At least 3 years of experience in a managed health care environment
Experience with health care program design, implementation, and evaluation
Knowledge of regulatory requirements for Medicaid, Medicare, and NCQA standards
Strong data management and analytic skills (including basic statistics or better)
Proficiency in analytical tools (SPSS) and Microsoft office (Excel, MS Project, Access, Visio)
including the ability to develop databases, forms, letters, and advanced queries
Ability to lead project team, meet or exceed deadlines and work with other dependencies outside the department related to the project
Excellent written and oral communication skills
Strong interpersonal communication skills with ability to effectively work with staff at all levels of the organization
Persuasion Skills: Persuade internal L.A. Care staff to attend and participate in collaboration of service improvement activities and complete tasks and activities in timely manner
Obtain reports from internal staff
Travel to offsite locations for work required
Nice to have
Master's Degree in Business Administration or Related Field
Project Management and analytical/problem solving skills
Statistical Analysis System (SAS)
Certified Professional in Healthcare Quality (CPHQ)