Program Manager

Texas Children's Careers•Bellaire, TX

About The Position

We are searching for a Program Manager. Someone who will support and maintain department programs; Manage regulatory communications and program requirements, monitoring performance through reporting and audits, and ensuring compliance with state, federal, and accreditation standards. Assists with internal and external audits, maintains and updates policies, procedures, and job aids, and supports workflow coordination across programs. Accountable for tracking productivity metrics and program goals, while providing operational and administrative support to ensure effective program delivery. Think you've got what it takes?

Requirements

Bachelor's Degree required
RN - Lic-Registered Nurses Texas Board of Nursing or Nurse Licensure Compact required
3 years' Experience in a health plan and utilization management required
3 years Program manager or related role with oversight of multiple programs preferred

Responsibilities

Assist with transition projects or initiatives or workflows related to HEDIS, NCQA and HHSC communication with day-to-day operational activities.
Identify key outcomes and metrics to track to assess effectiveness of programs.
Create/update policies, procedures, job aids, and training materials for applicable programs. Collaborate with Education to ensure training deployed to internal and external teams when needed.
Coordinates meetings with various stakeholders. Records meeting minutes and ensures follow up.
Stand up and schedule regularly scheduled audit and oversight activities for the new processes or program(s).
Manage the risks and issues that may arise from the course of the program life cycle. Take measure to correct them when they occur.
Ensure programs are compliant with regulatory and accreditation guidelines
Conduct regularly scheduled audits of vendors and provide summary report(s) and presentation(s) to leadership for committees.
Conduct internal audits to ensure productivity metrics are being met and protocols are being followed as needed based on program requirements or expectations of assigned department program.
Serve as lead for regulatory and accreditation requests.
Prepare necessary documents/materials accurately.
Coordinate with requesters in a timely manner.
Maintain repository of regulatory and accreditation required documentations.
Generate summary report(s) with audit outcomes.
Create presentation(s) and present audit findings to leadership and committees upon request.