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Managed Care Clinical Program Manager

Company: Cenpatico
Location: Rancho Cordova
Posted on: June 19, 2020

Job Description:

Managed Care Clinical Program Manager USA-California-Oakland, USA-California-Sacramento, USA-California-Rancho Cordova Position Purpose: The Clinical Program Manager is responsible for identifying, managing and tracking clinical, quality, correct coding, documentation and data submission projects that advance the objectives of Health Net s strategic goals. The Clinical Program Manager facilitates the development of internal and external reports and the delivery of data as needed to support and monitor the action plans to accomplish the Triple Aim: 1) to improve member experience, 2) improve the quality of care and 3) to reduce health care costs. * Responsible for managing and tracking clinical projects that advance the objectives of strategic plan with key provider groups and/or hospital systems by supporting established committees and creating new work teams; including such activities as organizing and publishing agendas, documenting minutes, maintaining work plans and monitoring open action items * Works closely with the Regional Medical Director to analyze data and develop and implement key interventions to support the Triple Aim, including developing work plans, workflows, policies and procedures, and serving as workgroup leader when appropriate in order to execute initiatives. * Serves as project leader for cross functional initiatives that are intended to drive performance improvement engaging across functional teams as needed to ensure effective communication of project requirements, as well as tracks progress of action plans. * Facilitates the development of clinical reports and the delivery of data to key provider partners; as well as develops internal reports to demonstrate progress. * Performs detailed analysis of data, workflows, policies, procedures and organization of staff, in order to execute initiatives. * May use project management software to support initiatives. Education/Experience: Bachelor s Degree in Nursing, International Medical Graduate, Master s Degree in Public Health (MPH), Hospital Administration (MHA) or Business Administration (MBA) . RN, RNP, LCSW strongly preferred. Five to seven years managed care, hospital or medical group experience, focusing on quality improvement, utilization management, or clinical operations. Project management experience at a medical group, IPA, or health plan setting. Experience analyzing and presenting data to drive outcomes. Experience making presentations in group settings. At least two years management experience Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. USA-California-Sacramento, USA-California-Rancho Cordova, USA-California-Woodland Hills, USA-California-Huntington Beach Clinical & Nursing Full-time

Keywords: Cenpatico, Rancho Cordova , Managed Care Clinical Program Manager, Executive , Rancho Cordova, California

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