Manager, CM Program Management

Job Locations US-MI-Kalamazoo
Req No.
2018-2317
Category
Operations
Type
Regular Full-Time

Overview

ConcertoHealth Inc. is the leading provider of specialized primary care and supporting clinical services for complex, frail, elderly, and dual-eligible patients. Operating exclusively in value-based agreements, ConcertoHealth provides high-touch, individualized care for patients, and deploys wraparound clinical resources to extend the reach of primary care practices. This comprehensive medical management solution, elevated by Concerto’s proprietary population health technology, improves overall healthcare quality and patient outcomes, benefitting payers and their provider networks.

 

Concerto delivers comprehensive care to Medicare, Medicaid, and complex-needs patients. The Concerto name reflects our unique approach to healthcare. It’s about how we work in concert with patients, providers, and health plans. Our approach focuses on bringing harmony across the spectrum of a patient’s care, health, and dignity.

 

The company is headquartered in Aliso Viejo, Ca. For more information, please visit: www.concertohealth.com

JOB SUMMARY

The Program Manager will serve in a critical capacity for the organization as he/she will be focused on operational excellence of Concerto’s health care programs. The Program Manager will be required to continuously assess the department operations against contractual, accreditation, and regulatory requirements as well as client policies, procedures and expectations.

 

Responsibilities

  • est practices that comply with contractual, regulatory, and accreditation requirements.
  • Coordinate ongoing meetings with staff and leadership to determine process improvement activities, coordinate workgroups to revise processes, pilot and finalize revised processes.
  • Document policies, procedures and workflows.
  • Collaborate with the program implementation department for new client implementations, new system development, and other implementations related to care management.
  • Assist with activities related to NCQA preparation and accreditation.
  • Coordinate activities with department leadership, staff, and with clinical training and auditing staff.
  • Assist in various projects and initiatives to prioritize and execute critical initiatives and ensure resources are deployed sufficiently to ensure successful implementation.
  • Take initiative and support all clinical areas with project activities.
  • Assist with tracking and implementing new business opportunities.
  • Develop key performance metrics to measure staff performance in collaboration with CM leadership; monitoring and escalating issues promptly.
  • Assist in requesting and evaluating appropriate reports.
  • Document Business Requirements Documents and collaborate with IT on information system modifications and reporting needs.
  • Collaborate with all business functions and support other initiatives that impact clinical areas.
  • Support CM Department leadership with ad hoc requests and projects.
  • Perform other duties as assigned by the AVP, Program Management.

Qualifications

  • RN licensure.
  • Bachelor’s Degree Preferred.
  • Minimum two years’ experience working in Care Management.
  • Project management and process improvement skills required.
  • Strong analytical skills required, including a thorough understanding of how to interpret business needs and translate them into application and operational requirements.
  • Excellent verbal and written communication skills
  • Ability to direct and execute complex data analysis to support any recommendations.
  • Deep understanding of upstream and downstream impacts of any solution implemented and ability to plan and execute to mitigate risks.
  • Self-driven/directed.
  • Ability to interact professionally with a diverse group, executives, managers, front-line staff and subject matter experts.
  • Strong ability to align objectives cross-functionally and drive change effectively.
  • Expert level proficiency with Microsoft Excel, Visio, PowerPoint and Word.
  • Experience with Tableau preferred but not required.

Options

Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
Share on your newsfeed