Process Improvement Project Manager

FLSA Status: Exempt Department: Quality Improvement Reports To: Manager, Process Improvement

GENERAL DESCRIPTION OF POSITION The Process Improvement Project Manager is responsible for supporting organizational and regulatory initiatives by leading the analysis and implementation of medium to large scale quality and process improvement projects and efforts. The Process Improvement Project Manager is responsible for working collaboratively and cross-functionally with internal and external stakeholders, including consultants, auditors, providers and surveyors to create efficiencies and quality improvements, as well as applying six sigma principals to processes at Santa Clara Family Health Plan (SCFHP). In addition, the Process Improvement Project Manager is responsible for developing work plans, gap analyses, survey readiness, and facilitating stakeholder collaboration for all projects assigned, including ongoing program planning and work stream facilitation in support of National Committee for Quality Assurance (NCQA) accreditation survey readiness.

ESSENTIAL DUTIES AND RESPONSIBILITIES To perform this job successfully, an individual must be able to satisfactorily perform each essential duty listed below.

• Lead and facilitate medium to large scale quality and process improvement projects by providing direction for project framing, organization, business case analysis, implementation, and outcome/success measurement. In addition to Process Improvement projects, other projects may include (but are not limited to) Quality Improvement Projects (QIPs), Performance Improvement Projects (PIPs), NCQA, and other projects as assigned.
• Drive adoption of process improvement across the organization by supporting and coordinating business change initiatives and activities associated with process improvements and system changes to ensure smooth transitions for stakeholders.
• Create, monitor and execute project work plans and deliverables, including working with the Manager of Process Improvement with ongoing NCQA program management.
• Develop and maintain all appropriate project documentation, including timelines, project scope, decision logs and work plans. This includes development of process documents including, process maps, workflows, and desktop procedures.
• Monitor timeliness of projects, cost management, and resource usage to ensure completion and implementation of project and budget variances.
• Identify, research, and resolve project issues and escalate critical issues, problems, and delays to management and executive leadership, as needed.
• Conduct studies of operations, workflows, and fact gathering sessions with stakeholders to document, quantify, and specify process improvement efforts. Work with internal stakeholders and business leaders to identify the gap between current and desired results.
• Analyze data in support of quality projects and collaborate with IT for data collection and/or report development, as needed.
• Develop and distribute timely project communications and status updates.
• Participate in meetings and conference calls with regulatory agencies (i.e. Federal, State and County), NCQA, SCFHP management, delegates and vendors to obtain and capture requirements and timelines.
• Understand and track applicable regulatory and reporting requirements. Document and report quality project results to Plan Management, DHCS, CMS, and HSAG.
• Perform other related duties as required or assigned.

REQUIREMENTS - Required (R) Desired (D) The requirements listed below are representative of the knowledge, skill, and/or ability required or desired.

• Bachelors Degree in Management, Business, Healthcare, or a related field, or equivalent experience. (R)
• Minimum two years of project management experience. (R)
• Ability to effectively facilitate meetings and deliver information/presentations. (R)
• Experience with health care program evaluation, design, and implementation. (D)
• Knowledge of regulatory requirements for Medicaid, Medicare, and NCQA standards. (D)
• Ability to organize, plan, direct and manage medium to large scale, complex, cross-functional, multi-departmental projects. (R)
• Strong organizational skills; able to adapt to changing environment, work independently, and manage multi-task responsibilities. (R)
• Ability to work with a high level of independence with strong collaboration and relationship management skills. (R)
• Strong analytical and problem solving abilities. (R)
• Knowledge of operational areas, quality improvement, IT, and health services in a health plan or integrated delivery system. (D)
• Project management certification. (D)
• Working knowledge of process improvement methodologies. (R)
• Lean or Six Sigma certification. (D)
• Working knowledge of and the ability to efficiently operate all applicable computer software including computer applications such as such as MS Word, Excel, Power Point, Visio, Project and Outlook. (R)
• Ability to use a keyboard with moderate speed and a high level of accuracy. (R)
• Excellent communication skills including the ability to express oneself clearly and concisely when interacting with internal and external stakeholders over the telephone, in person or in writing. (R)
• Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R)
• Ability to assume responsibility and exercise good judgment when making decisions within scope of the position. (R)
• Ability to maintain confidentiality. (R)
• Ability to comply with all SCFHP policies and procedures. (R)
• Ability to perform the job safely and with respect to others, to property and to individual safety. (R)

WORKING CONDITIONS Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications.

PHYSICAL REQUIREMENTS Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation:

• Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R)
• Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R)
• Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R)
• Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment (R)
• Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R)
• Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. (R)

ENVIRONMENTAL CONDITIONS General office conditions. May be exposed to moderate noise levels.