Quality Improvement Project Manger

The QI Project Manager is a healthcare project specialist who will be responsible for managing day-to-day operations of a portfolio of projects, and providing support for ongoing special projects. In this role, the project manager will be responsible for ensuring program activities are completed in a high quality and timely manner and ensuring compliance with all regulatory guidelines such as Medicaid (Medi-Cal), Medicare, Health Exchange, Healthy Kids, as well as NCQA Accreditation. Successful candidate must have excellent project management, analytic, reporting, and written and oral communication skills. In addition, candidate should be detail oriented and self-motivated.

RESPONSIBILITIES:

- Implementation of any new product lines.
- Data collection and analysis using internal data and using various analytic tools to develop interventions to improve overall member satisfaction, such as grievances and appeals data, surveys, and network access and availability.
- NCQA Accreditation readiness and oversight.
- Delegation oversight.
- Vendor contract management and operations.
- Inter-departmental committee participation.

SKILLS:

EDUCATION/EXPERIENCE:

- Bachelors or Master's Degree in business or health care required.
- Masters degree in health care or public health (ie, MPH, MHA, MBA, MPP, or similar) is preferred.
- At least 3-5 years experience in a managed health care environment.
- CPHQ certification preferred.

SKILLS/QUALIFICATIONS:

- Knowledge of regulatory requirements for Medicaid, Medicare and NCQA standards.
- Strong data management and analytic skills (including basic statistics or better).
- Experience with health care program design, implementation and evaluation.
- Familiarity with Microsoft Excel and Access (including data management, basic queries, forms, and reports) is required.
- Knowledge of Visio, MS Project, SPSS, and/or SAS.
- Candidate will be well-rounded and versatile, possessing strong project management, analytical, collaborative, and communication skills, and will be enthusiastic about improving health care delivery.
- Must be proficient in Microsoft Office, including the ability to develop databases, forms, letters, and advanced queries.
- Proficiency in analytic tools, such as Access, SPSS and/or SAS is preferred.