Quality Program Strategist Jobs

2-3 years managed care and/or healthcare experience

1-2 years’ experience in health equity field

Experience working with medication use quality and quality measures

Demonstrates through exceptional planning and organizational skills a record of bringing tasks and projects to successful conclusion

Exceptional communications and interpersonal skills

Demonstrates leadership skills with ability to work collaboratively in matrix environment to produce results across functional teams

Provide project management and logistical solutions.

Demonstrated ability to execute advocacy campaign-related deliverables, such as convenings, reports, sign-on letters, partnership agreements, and/or relationship-management databases.

Contribute to program’s media and public education work, including strategy, talking points, and speaking engagements.

A bachelor’s degree and 2-5 years of relevant experience are required.

Experience holding full-time responsibility in a campaign setting such as electoral campaigns, issue or legislative campaigns, or community organizing.

Strong interpersonal skills and the desire and ability to build and maintain positive relationships within and outside the organization.

Experience: Five years of experience in developing, implementing, administering, and evaluating programs, to include responsibility for regulatory or quality management.

Mental and Emotional Requirements: Manages stress appropriately.

Education: Bachelor’s Degree in Science, Nursing, Healthcare, Business, or a directly related field.

Certification(s): Specific certification(s) may be required depending on the position.

Prepares presentations and training materials for public education and awareness programs; delivers presentations at conferences, public meetings, and seminars.

Mental and Emotional Requirements: Independent discretion/decision making.

Strong organizational and time management skills, including ability to work independently and prioritize multiple projects and assignments

Collaborates with key internal stakeholders and Plan’s pharmacy benefit manager to identify areas of potential cost-saving and quality improvement initiatives

Conducts quality assurance analyses of utilization management reviews to ensure consistency and appropriate decisions in accordance with Plan policies

Responsible for implementing clinical policy updates and training of staff in the application of policy criteria to utilization management reviews

Experience in a managed care setting, either from the provider, the payer, or the PBM side of the industry, is preferred

Leads pharmacy services activities related to NCQA to ensure accreditation requirements are met and maintained for ongoing reaccreditation

Strong self-starting and communication skills

Relies on extensive experience and judgment to plan and accomplish goals.

Vet lessons learned from project teams for content validity and proper context

Facilitate collaboration as needed with key stakeholders

Identify opportunities for process improvement and efficient cross functional operations

Review departmental SOPs and ensure compliance with project teams

Coordinate major work deemed of critical importance (e.g. regulatory requests, cost savings initiatives) utilizing project management principles and documentation

Participate in regulatory and compliance audits as needed to provide data management and analytic support

Bachelor degree in Health Care Management, Public Health, Nursing, Information Technology/Computer Science or other health care field required

Minimum of 3 years of experience in a managed care environment required

Commensurate educational experience in related field will be considered

2 or more years of experience in Medicaid Managed Care organization strongly preferred

Manage multiple programs/projects from inception through completion to meet or exceed budget, schedule, and scope/quality requirements

Ability to work comfortably at all levels within the organization up to the senior management level required

Monitors cost and schedule performance to baseline plans, takes action to manage risk, and deploy resources to achieve objectives

Ensure that CAPAs meet or exceed all internal and external regulatory requirements

Address any lack of compliance and potential areas of compliance vulnerabilities.

Provide training, as required, to manage QMS processes.

Confident and comfortable with creating reports and presentations to upper management.

Program manage the RIS Factory White Glove Program assuring factory quality for high profile RIS customers.

Lean Six Sigma or other Quality certification preferred.

Strong analytical, statistics, and problem-solving skills.

Functional operation of typical AiO, tablet, and desktop PCs with applied knowledge to Retail Point of Sales hardware and peripherals.

Use of empirical and root- cause analysis and modeling to capture customer product issue experience for replication.

Consumer Education & External Affairs - Consumer Response

As a Program Manager (Quality), you will:

Open to CFPB employees only (Competitive service permanent)