Sr. Program Manager

Job Description

Leads and manages the day-to-day operational and tactical aspects of multiple or enterprise scale projects, new initiatives and other ongoing business deliverables in accordance with business needs. Identifies, evaluates and resolves issues that conflict with project deliverables. Collaborates closely with project team members, business owners and sponsors to develop and successfully implement projects/programs. Assesses project risks, develops mitigation and contingency plans. Oversees project to ensure projects have required resources, meets milestones and are successfully implemented. Leads and coordinates matrix and/or cross-functional team.

What You'll Do

• Review reports and records of activities to ensure progress is being accomplished toward specified program objective and modify or change methodology as required to redirect activities and attain objectives.
• Support clinical quality leadership on planning activities and large operational activities; works with Clinical Quality leaders to define success metrics and criteria.
• Develop, implement, and manage, moderately complex programs in accordance with guidelines. Work with program/project team and internal/external stakeholders to ensure deadlines are met.
• Manage and coordinate activities concerned with implementation and carrying out objectives of programs.
• Responsible for keeping current with HEDIS specifications and ensuring that all contractors and overreaders are knowledgeable about the latest updates.
• Identify, analyze, and understand target audiences and their specific program needs. 
• Performs quality audits of member medical records to ensure compliance with HEDIS specifications.
• Assists in designing effective learning solutions based on analysis of quality audit results and when quality deficiencies are identified.
• Monitors and reports on individual and department results to include benchmarking and trending.
• Works with management team to support decisions on workflow process, quality improvement, goal setting and data driven information-based decision-making.
• Provides timely feedback to management on HEDIS performance.
• Manage end to end HEDIS record review process. This includes oversight of reviewers, managing chase list process, manage reporting, tracking IRR’s, etc.
• May also support ongoing administration of larger and/or more complex programs.
• Establish and monitor performance metrics and goals for assigned programs, including process measures, outcomes measures, financial measures, and methodologies for implementing programs. Document and present program results through operational reports, outcomes studies, presentations, and publications.
• Serve as a subject matter expert in routinely briefing key stakeholders on different aspects of assigned initiatives.
• Manage vendor relationships and/or work closely with vendors.
• Other HEDIS duties or ad hoc requests, as assigned.

Knowledge and Experience

Strong analytical, organization, and problem-solving skills.

Strong written, and verbal communication skills and ability to successfully interact with …