Specialist Outpatient Program at Prospect Medical Holdings, Inc. in Orange, California

Job Description:

Job Summary:
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The Outpatient Program Specialist will work with Prospect's Outpatient Program Leadership and be responsible for assisting with the coordination and/or completion of activities within Outpatient Programs. Responsibilities includes but are not limited to the following: supporting the department team leads on implementing process improvement initiatives and/or new business/projects; development, analysis, and reporting of program metrics; assist in development and maintenance of department's processes, job aids, and workflows; provide project management, analytical, and administrative support for the program.With approximately 9,000 physicians to serve our 260,000 members, Prospect Medical Systems is proud to be among the most innovative medical systems in California, Texas and Rhode Island. Our extensive care services range from primary care and specialty physician services to acute care hospital and skilled nursing facilities to behavioral health and wellness services. Each of our Independent Physician Associations (IPAs) and networks support the use of advanced diagnostic and treatment tools to provide our members with convenient access to state-of-the-art healthcare. For 25+ years, Prospect Medical has been focused on our mission of supporting independent physicians where, through risk arrangements, we work closely together with health plans, facilities and healthcare physicians for the benefit of every person who comes to us for care. We provide quality healthcare services that are designed to offer our patients highly coordinated, personalized care and that help them live healthier lives. Prospect Medical Systems manages highly successful IPAs by leveraging our best-practices, results-driven administrative services to manage patients under risk arrangements with health plans/CMS.Required Education:

• Requires a high school diploma and a minimum of 1 year of project management experience required


• Experience with data analysis and reporting.


• Strong computer skills. Proficient in Microsoft Word, Visio, Power Point, Excel, Outlook and other applicable systems needed for the role

• Associates Degree or higher preferred


• Knowledge of Six Sigma or other equivalent process improvement training


• Knowledge and prior experience with Managed Care organization.


• Equivalent experience will be considered

• Ability to prioritize and multi-task


• Excellent communication skills


• Strong organization skills


• Maintain professional attitude when working with internal and external customers


• Maintain and ensure confidentiality of patient information

This role is 100% remote.

Plan, coordinate, support, and complete activities for various process improvement targeted projects and initiatives as assigned. Will also include new business and projects support. Assist in evaluating, analyzing, and reporting of Outpatient program metrics through creation of dashboards, reports, and trackers. Researches and identifies opportunities for process improvements, provides analysis and recommends change strategies, and creation of short- and long-term goals/priorities for the department. Manage detailed project plan development and adherence to and tracking of status, timeline, and completion. Participates in internal and external meetings and present on report findings and trends to leadership and team as appropriate. Assist in the development and maintenance of Outpatient programs policies and procedures, processes, job aids, and workflows. Assists with documenting meeting minutes, notes, and other materials as necessary. Facilitate Plan-Do-Study-Act cycles. Demonstrates the ability to follow through with requests, sharing of critical information, and getting back to individuals in a timely manner. Interacts professionally with internal team, other departments, leadership, and stakeholders. Maintains current knowledge of clinical operations, health plan policy, regulatory requirements, and standards of practice for Outpatient programs. Maintains compliance with established departmental productivity guidelines. Complete required Health plan and company trainings. Completes other projects and duties as assigned.

Job Knowledge, Skills and Abilities:

To perform this job successfully, an individual must be able to perform the job description satisfactorily. This job description reflects management's assignment of essential functions, it does not prescribe or restrict the tasks that may be assigned. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Knowledge of HIPAA regulations preferred


• Excellent written and verbal communication skills (60 WPM)


• Exceptional customer service and conflict resolution skills


• Must be able to work independently.


• Ability to multi-task, prioritize, and work in a fast-paced environment


• Must be proficient in Microsoft Office navigation, Excel, Outlook, Teams, and Word and/or IDX knowledge.

This role is 100% remote.

Plan, coordinate, support, and complete activities for various process improvement targeted projects and initiatives as assigned. Will also include new business and projects support. Assist in evaluating, analyzing, and reporting of Outpatient program metrics through creation of dashboards, reports, and trackers. Researches and identifies opportunities for process improvements, provides analysis and recommends change strategies, and creation of short- and long-term goals/priorities for the department. Manage detailed project plan development and adherence to and tracking of status, timeline, and completion. Participates in internal and external meetings and present on report findings and trends to leadership and team as appropriate. Assist in the development and maintenance of Outpatient programs policies and procedures, processes, job aids, and workflows. Assists with documenting meeting minutes, notes, and other materials as necessary. Facilitate Plan-Do-Study-Act cycles. Demonstrates the ability to follow through with requests, sharing of critical information, and getting back to individuals in a timely manner. Interacts professionally with internal team, other departments, leadership, and stakeholders. Maintains current knowledge of clinical operations, health plan policy, regulatory requirements, and standards of practice for Outpatient programs. Maintains compliance with established departmental productivity guidelines. Complete required Health plan and company trainings. Completes other projects and duties as assigned.

Job Knowledge, Skills and Abilities:

To perform this job successfully, an individual must be able to perform the job description satisfactorily. This job description reflects management's assignment of essential functions, it does not prescribe or restrict the tasks that may be assigned. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Knowledge of HIPAA regulations preferred


• Excellent written and verbal communication skills (60 WPM)


• Exceptional customer service and conflict resolution skills


• Must be able to work independently.


• Ability to multi-task, prioritize, and work in a fast-paced environment


• Must be proficient in Microsoft Office navigation, Excel, Outlook, Teams, and Word and/or IDX knowledge.