Job Summary: Under the direction of the Senior Director of Performance Improvement, the Manager of Performance Improvement (PI) Clinical Operations is responsible for managing the Clinical Operations of PHP Wellness Centers, and our partner medical providers. This position will oversee the PCP Enablement team that includes medical assistants and outreach specialists that support PCP practices as embedded resources. Manages resources, streamlines processes, develops and executes tactics and coordinates capacity, level of support needed and all operational elements including schedules, education, deployment of strategies and campaigns in support of Risk Adjustment and Quality in all settings. This resource collaborates with Senior Management within Performance Improvement to ensure the execution of strategic goals.

Duties and Responsibilities:

• Manage and streamline clinical operations for Prominence Wellness Centers through data collection, process shadowing, analysis, and process improvement
• Analyzes data for patterns and trends in care delivery; works on discovering root causes for specific member care trends and develops viable solutions
• Identify performance improvement opportunities in processes, workflows in both PHP clinics and partner clinics
• Plan, execute and monitor the deployment of strategies that support Risk Adjustment and Quality
• Oversee and manages productivity and quality of clinical and outreach team against KPIs and operational metrics through creating remediation plans
• Provide subject matter expertise in clinic workflow, schedule management, E2E processes
• Partners with subject matter experts in Risk Adjustment and Quality to design, manage and deploy campaigns and track performance
• Collaborate with Performance Improvement leadership to ensure the execution of strategic goals
• Identify opportunities to maximize resources and staffing allocations in clinics and PCP offices
• Deploy and manage staff resources in alignment with Performance Improvement Goals
• Coordinates coverage, onboarding, and training of all clinical and supporting staff at wellness centers and partner clinics
• Manage and support the relationship with provider offices and vendor partners including onboarding and escalation
• Leads the execution of member events and other strategies in clinics
• Manages equipment procurement, vendor relationship, troubleshooting and escalation of screening devices issues ta wellness centers and clinic partners .
• Collaborate in the development and update of quality/performance improvement policies

Requirements:

• BS, Business, or related field; MS preferred
• Minimum five (5) years’ experience managing a primary care clinic for Medicare or Medicare Advantage population
• Minimum three (3) years’ proven continuous improvement experience in Clinical Operations and process flow
• 5 yrs supervisory/managerial experience
• Good understanding of continuous improvement concepts including Six Sigma, Lean, value stream mapping
• Working knowledge of Quality Measures, clinical documentation
• Ability to set-up, facilitate and lead service improvement sessions with a range of business stakeholders
• Experience in designing remediation plans to address productivity and efficiency issues, and a track record of following through to ensure closure
• Strong presentation, critical thinking and problem-solving skills
• Medical Group/Physician office background preferred
• Ability to effectively communicate in English, both verbally and in writing
• Ability to understand, analyze and present data
• Working knowledge of Medicare and/or Commercial risk adjustment programs preferred
• Proficient in the use of Microsoft Office, including Project, Visio, Word, Excel, Outlook, PowerPoint and database applications

Job Type: Full-time

Pay: $75,403.93 - $113,105.89 per year

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Employee discount
• Health insurance
• Paid time off
• Referral program
• Tuition reimbursement
• Vision insurance

Schedule:

• Day shift

Application Question(s):

• Do you have a minimum five (5) years’ experience managing a primary care clinic for Medicare or Medicare Advantage population?
• Do you have minimum three (3) years’ proven continuous improvement experience in Clinical Operations and process flow?
• Do you have 5 yrs supervisory/managerial experience?

Education:

• Bachelor's (Required)

Work Location: One location

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