Quality Improvement Project Manager II

L.A. Care Health Plan•Los Angeles, CA

4d•$77,265 - $123,625•Onsite

About The Position

The Quality Improvement Project Manager II is a healthcare project specialist responsible for managing the day-to-day operations of a portfolio of projects and providing support for ongoing special projects within L.A. Care's Quality Improvement Department. This role ensures program activities are completed in a high-quality and timely manner, adhering to all regulatory guidelines such as Medicaid (Medi-Cal), Medicare, Health Exchange, and Healthy Kids, as well as National Committee for Quality Assurance (NCQA) Accreditation. The successful candidate will possess excellent project management, analytic, reporting, and written and oral communication skills, and be detail-oriented and self-motivated. This position involves various quality improvement projects including implementation of new product lines, data collection and analysis to improve member satisfaction, NCQA Accreditation readiness, delegation oversight, vendor contract management, Nurse Advice Line management, and inter-departmental committee participation.

Requirements

Bachelor's Degree (equivalent education and/or experience may be considered in lieu of degree).
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 a timely manner. Obtain reports from internal staff.
Travel to offsite locations for work required.

Nice To Haves

Master's Degree in Business Administration or Related Field
Project Management and analytical/problem solving skills.
Statistical Analysis System (SAS) preferred
Certified Professional in Healthcare Quality (CPHQ)

Responsibilities

Design and management of a portfolio of assigned projects within budget to ensure timely and accurate delivery in compliance with regulatory requirements, NCQA Standards, and other established metrics.
Present quarterly quantitative and qualitative performance analysis and reports to Quality Oversight Committees and other committees.
Monitor the performance of current service interventions and 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.
Assess projects at least annually to determine if they are meeting performance goals and provide a project plan for continuous quality improvement.
Identify, recommend, and apply business solutions derived from research and analysis findings to gain departmental efficiencies.
Document existing business processes and industry best practices, including workflows of existing processes and interdependencies.
Create 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, ensuring 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, ensuring documentation is in compliance with company protocol.
Perform other duties as assigned.