Manager, Performance Programs - Full Time, Days (Remote) at Prospect Medical Systems - CA in Los Angeles, California

Posted in General Business 1 day ago.

Type: Full-Time





Job Description:

Manager, Performance Programs - Full Time, Days (Remote)

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

The Performance Program Manager is responsible for the planning, organization, and successful execution of one or more performance programs for the company. Program consists of CMS STAR management to reach the highest attainment possible P4P, HEDIS, and Total cost of Care. The PPM is responsible for the motivation of the team to achieve measurable gains within the programs, as measured by internal and external metrics. Ensures the quality and timeliness of work performed, supervises and assists in the gathering of data (supplemental or otherwise) and the accurate entry into all systems and subsystems. Coordinates communications between members, staff, providers and Health Plans. Demonstrates the ability to work on multiple, complex projects and manages communication between staff, providers, health plans and members.

Job Responsibilities/Duties


  • Manage, select, hire, train and motivate staff to achieve day-to-day and long- range operational goals.
  • Coordinate resources required to meet the business units' objectives. Manage the resolution of problems that are escalated.
  • Continually review and appraise the progress and performance of staff and design developmental programs tailored to meet their career goals. In conjunction with the Director, establishes yearly department goals.
  • Continually assess potential project risks and creates and implements corrective action plans and develops new procedures resulting in additional revenue for the company.
  • Initiates new programs, enhances existing programs and continuously assesses need for resources, tools and add-ons.
  • Provides excellent and comprehensive communication and education to internal and external staff and customers.
  • Assists with Provider, staff and member training. May coordinate and oversee annual chart audits collection, HP chart requests, claim or payment resolution, etc.
  • Initiates member and provider communication relating to missing tests, measures and "due" reports.
  • Produces accurate staff and "measure" productivity reports in a timely manner.
  • Identifies areas that need improvement and initiates creative solutions (cost effective) to correct problems.
  • Ensures proper notification to clients and customers has been performed.
  • Produces accurate metrics reports as well as staff productivity reports in a timely manner.
  • Identifies areas that need improvement and initiates creative solutions (cost effective) to correct issues to meet and exceed our stated goals.

Qualifications

Minimum Education: Bachelor's Degree with emphasis in business administration, IT or Health care preferred or equivalent experience.

Minimum Experience: Five or more years' experience in project coordination or management of small, medium and large projects desired. Experience in health care desirable.

Req. Certification/Licensure: None.

Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals, benefit eligible positions will receive:


  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance

How to Apply

To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www.eeoc.gov/





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