Program Manager III, Medicare Risk Adjustment & Chart Review

Kaiser Permanente • Rockville, MD

76d

About The Position

The Program Manager III for Risk Adjustment and Chart Review is responsible for overseeing the accuracy and efficiency of risk adjustment processes and retrospective chart reviews. They will support the management and oversight of internal and vendor chart retrieval operations, including performance reporting, SLA tracking, and data reconciliation. This role manages small-to-medium sized projects/programs or components with multiple workstreams and strategic business goals across departments, functions, or regions with responsibility and accountability for achieving program outcomes from initiation to close-out in an extended or open-ended time frame.

Requirements

• Bachelors degree from an accredited college or university and minimum three (3) years project management experience OR minimum six (6) years experience in project management or a directly related field.
• Applied Data Analysis
• Financial Acumen
• Conflict Resolution
• Managing Diverse Relationships
• Project Management Tools
• Risk Assessment
• Quality Assurance Process
• Service Focus
• Strategic Program Management
• Change Management

Responsibilities

• Leads the work of project/program teams by coordinating and monitoring internal and/or external resources.
• Monitors and identifies project/program risks, issues, and trigger events by executing mitigation plans and strategies.
• Monitors compliance of project/program activities by ensuring project/program plans and team members adhere to relevant policies and procedures.
• Ensures the alignment, buy-in, coordination, and support of diverse stakeholders.
• Assists with reviews of vendor performance levels, ensures service level agreements are met, and supports contract negotiations with vendors.
• Pursues effective relationships with others by proactively providing resources, information, advice, and expertise.
• Listens to, seeks, and addresses performance feedback; provides mentoring to team members.
• Supports and responds to the needs of others to support a business outcome.
• Completes work assignments autonomously by applying up-to-date expertise in subject area to generate creative solutions.
• Collaborates cross-functionally to solve business problems; escalates issues or risks as appropriate.
• Identifies, speaks up, and implements ways to address improvement opportunities for the team.
• Develops, analyzes, and executes less complex project/program plans which include scope identification and management, schedule, inter-dependencies, and resource forecast.
• Manages project/program financials for small-to-medium size programs.
• Monitors project/program performance to ensure initiatives effectively deliver maximum long term value or benefit to the organization.
• Manages project/program activities related to organizational change management.
• Allocates resources, establishes schedules, and makes task assignments.
• Promotes program vision and objectives with project/program team.
• Communicates tough issues to stakeholders while maintaining an independent opinion.

What This Job Offers

• Industry: Ambulatory Health Care Services
• Education Level: Bachelor's degree