Job Description

Job Title: Government Quality Program Manager
Job ID: 738136
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Quality Improvement
Location: 600 Grant St, Pittsburgh PA 15219

Description

UPMC Health Plan is hiring a full-time Government Quality Program Manager to help support the performance improvement activities for the Government Programs for its downtown Pittsburgh location at the U.S. Steel Tower. The government programs include UPMC for You Medical Assistance Program and UPMC for Kids CHIP Program.


This candidate will provide overall project management related to the Pennsylvania Department of Human Services (DHS) Performance Improvements Projects (PIPs) requirements and the NCQA performance measures required for UPMC for You Medical Assistance Program to achieve the Health Plan’s goal of excellence. The successful candidate will organize quality improvement activities and supports various functions within the scope of the Health Plan’s Quality Improvement Program, working both independently and as a team member. This position will provide direction, leadership, and accountability for project management efforts among various departments as well as across the system; define project objectives and measures to be tracked by the responsible business owners; develop and maintain detailed project plans; and produce final versions of reports for submission to the DHS. The functions include but are not limited to regulatory and accreditation standard adherence, development and implementation of Process Improvement Project plans (PIPs), interventions to improve performance, qualitative and quantitative analysis of results, barrier analysis, root cause analysis, performance monitoring and assessment, education of internal and external work groups on the established measures, and the continual advancement of the quality improvement process as a means to achieve the Health Plan’s goal of excellence. This is a Monday through Friday daylight position.

 

 

Responsibilities:

  • Develop and maintain detailed project plans, including utilizing standard project documentation, methodology, project tracking, and reporting procedures
  • Completes research related to improvement activities, requests data, reviews reports and summarizes findings.
  • Develop cross-functional, change management and implementation strategies
  • Ensure that all participating parties have committed to effective implementation of the processes and procedures
  • Obtains information from clinical staff or other areas on interventions implemented related to opportunities.
  • Assist cross-unit team members in resolving project problems, escalate issues when necessary, and facilitate decision-making
  • Develop and implement key metrics to measure and report on progress of initiatives
  • Maintain project planning documents, prepares materials and performance improvement documents in format required by government agency, regulatory body, or accrediting body.
  • Identify trends and process improvement opportunities across departments within operations
  • Monitor operating performance against regional and national benchmarks
  • Provide concise and timely status reporting as required
  • Submits all required regulatory documents before deadline
  • Work with other managers to achieve efficiencies across integration of projects
  • Perform duties and responsibilities in accordance with the philosophy, standards and policies and procedures of the UPMC Health System, including conveying courtesy, respect, enthusiasm and a positive attitude through all contacts with staff, health plan members, providers, peers and visitors
  • Performs other duties as assigned

Qualifications

  •  Bachelor's degree in business, mathematics, statistics, health care, management, or related business field required. BSN preferred
  • Minimum of four years of related project or program management work experience.
  • Master's degree preferred (Four+ years' experience will be considered).
  • Experience in health care insurance or health care industry preferred
  • Prior experience with NCQA, HEDIS, CAHPS is highly preferred
  • Excellent computer skills required including Microsoft Excel, Word, PowerPoint
  • Prefer experience with Microsoft Project, Access and other pertinent computer software packages
  • Excellent writing skills, verbal, and presentation skills is highly preferred
  • Strong management, problem solving, organizational and communication skills is highly preferred
  • Ability to work independently, as a productive team member, and a leader of multi-disciplinary work groups is essential
  • Ability to perform planning for large initiatives/projects, managing all tasks required to providing services to meet client and business needs within budget and targeted deadlines.
  • Professionalism, enthusiasm and initiative are excepted



    Licensure, Certifications, and Clearances:
    PMP Certification is highly preferred.

    UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $30.89 to $52.76

Union Position: No

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