Rego Park, New york
Project Manager - Quality Healthcare Management Job Opening in Rego Park, New york - Fidelis Care offers quality, affordable coverage to residents across the State of New York, including products available through Medicaid, Medicare and the NY State of Health. Fidelis Care was founded on the belief that all New Yorkers should have access to affordable, quality health insurance and that remains our mission to this day to our 1.6 million members.
The Project Manager develops and implements Quality Health Care Management (QHCM) projects and processes to assure regulatory compliance and continued improvement in the effectiveness of programs; provide project management, staff training if appropriate, and oversight of projects.
Develop and implement programs in collaboration with Director of Clinical Services as required for Senior Programs including but not limited to CCIP, QIP, MOC, and Structure and Process.
Collaborate with Clinical Service staff to understand the results of program performance and develop improvement plans.
Collaborate with Informatics, QM, UM, and Clinical Services, Member Services, Provider Relations, and Finance; develop and implement programs in collaboration with Director of MLTC as required by State and Federal regulations, particularly performance improvement programs, analysis of utilization and resource management, hospitalization, and nursing home admission rates.
Work with MLTC staff to understand the results of program performance and develop improvement plans; increase cooperation and collaboration by all departments in support of MLTC expansion.
Develop and implement work processes for the collection, analysis, and transmission of Health Home quality measures as required by SDOH for Health Home function.
Evaluate the effectiveness of particular QHCM outreach, educational, or care management programs; identify appropriate metrics to measure, collect data and providing analysis and recommendations in collaboration with the appropriate Medical Director.
Provide Project Management leadership to projects as assigned by Medical Director.
Work-Related Experience:
Three to five years related experience required.
Quality Improvement QARR, Health Plan, Medicare, and Senior Programs preferred.
Proficiency in Microsoft Office: Excel, Word, Access; Lotus Notes; Internet.
Business Analysis Knowledge: Skilled to work in a fast paced environment. Must have strong analytical and problem solving skills. Ability to work well as a member of a team or alone.
Customer Service: Skilled to communicate with all levels of management, internal and external customers.
Qualifications:
BS required
Master's Degree preferred
To learn more about our Mission and growing company, please visit
Job Type: Full-time
Required education:
Bachelor's
Required experience:
Healthcare Project Management: 3 years
|
