Health Care Improvement Quality Improvement Manager- 014350

This position evaluates, designs, executes, measures, and monitors process improvements within scope of project and/or team charter. The position is accountable for leading improvement efforts and appropriate changes in a process that will create a favorable impact. The position requires the individual work collaboratively in cross-functional teams. The position is responsible for delivering projects and programs to improve the health plan’s quality ratings.

Essential Responsibilities/Accountabilities:

• Initiates, drives, and leads high level analysis of processes and outcomes to identify opportunities to improve health plan ratings on a universe of measures and Corporate Quality Action Plan goals and objectives

• Introduces innovation into the process that can impact results, enhance ratings and assist the organization to meet its Health Care Improvement (HCI) strategic objectives and goals.

• Plans, directs, and coordinates matrixed team activities to manage and implement quality improvement interventions from implementation to conclusion.

• Responsible for managing work teams surrounding quality improvement efforts.

• Plans, schedules, monitors, and reports on activities related to the quality improvement intervention.

• Monitors, reports, and communicates outcomes on the progress of the work team and intervention, using data analytics, power point presentations and process improvement tools.

• Identifies and assembles talent and additional resources throughout the organization to meet intervention needs and requirements.

• Ensures that team activities and interventions meet timeframe goals.

• Coaches and counsels members of intervention team to complete tasks and accomplish outcome/goals.

• Conducts outreach to members based on needs identified during intervention planning, as needed.

• Meets with management to review intervention status/progress and invokes appropriate escalation to resolve barriers.

• Establishes appropriate process and outcome measures to ensure improvement effectiveness of intervention for measuring key project criteria.

• Acts as change agent implementing quality improvement changes that drive higher quality ratings.

• Monitors and evaluates quality of performance and product from all work within scope of responsibility.

• Selects and applies appropriate tools to accurately produce work plans. Works with colleagues to produce/recommend/develop long-term plans.

• Fosters an environment of continuous improvement. Constantly exploring ways to increase efficiencies and productivity, reducing waste, and reducing costs.

• Monitors, reports, and communicates outcomes on the progress of the work team and intervention, using data analytics, power point presentations and process improvement tools.

• Maintains knowledge of health insurance industry and Health Plan business, organizational policies, and organizational management structures and uses this knowledge to advise on and justify their current use.

• Writes and speaks fluently on all aspects of work. Communicates effectively with all levels of management. Directly negotiates with and functions as a liaison to ensure intervention goal is met.

• Acts professionally at all times and encourages professional standards.

• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct and leading to the Lifetime Way values and beliefs.

• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.

• Regular and reliable attendance is expected and required.

• Performs other functions as assigned by management.

Minimum Qualifications:

• Bachelor’s degree and a minimum of three years’ progressive experience in process improvement work (i.e. Analyst or Project Mgr, quality improvement).

• Expert knowledge of Health Plan Operations and understanding of its operating teams and their functions. A minimum of three years’ experience in quality improvement.

• Must possess strong organizational, planning, and interpersonal skills. Have the ability to work with multiple departments, and establish matrix relationships with all levels of internal staff and management.

• Knowledge of basic quality measurement concepts and improvement tools/techniques and processes.

• Strong problem solving skills.

• Experience and proven success in using Plan, Do, Study, Act process improvement cycle.

• Knowledge of health insurance industry, federal and state regulations, accreditation standards, and advancements put forth by quality improvement organizations (including but not limited to NCQA, CMS, The Joint Commission, and NYS DOH) preferred.

• Demonstrated leadership skills.

• Highly Effective communicator.

• Demonstrated skills in quality principles especially root cause analysis and problem solving.

Physical Requirements:

• Position requires working from a desk, a majority of the day.

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The Lifetime Healthcare Companies aims to attract the best talent from diverse socioeconomic, cultural and experiential backgrounds, to diversify our workforce and best reflect the communities we serve.

Our mission is to foster an environment where diversity and inclusion are explicitly recognized as fundamental parts of our organizational culture. We believe that diversity of thought and background drives innovation which enables us to provide leading-edge healthcare insurance and services. With that mission in mind, we recruit the best candidates from all communities, to diversify and strengthen our workforce.

OUR COMPANY CULTURE:

Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.

Equal Opportunity Employer