Are you passionate about improving the quality of healthcare?
Are you ready to leverage your talents to make healthcare better for everyone?
Do you want the opportunity to give back to your community?
Do you want to have fun at work?
Then join the growing team at Health Services Advisory Group (HSAG) that is transforming the delivery of healthcare in the United States!
Under limited direction, the Project Manager is responsible for monitoring and supporting HSAG’s compliance with State external quality review (EQR) contracts. Ongoing support includes developing and managing work plans, organizing and conducting project work, meeting project timelines and deliverables, and ensuring follow-up, as necessary. This position is responsible for working with and managing both internal and external resources to achieve corporate, department, and project goals and objectives.
Essential Competencies, Duties, and Responsibilities
- Conduct/lead on-site compliance reviews of Medicaid managed care health plans based on CMS protocols, in alignment with federal regulations and State contract requirements. Onsite compliance reviews require travel. (Up to 20% travel per year with no travel in 2021 due to COVID-19 pandemic.)
- Conduct EQR review activities including creating compliance review tools and materials, coordinating compliance report preparation, communicating with the State and managed care plans regarding report findings, and finalizing reports.
- Review corrective action plans, make recommendations, and determine appropriateness.
- Develop content and recommendations for annual technical reports.
- Participate in external quality reviews of managed care entities based on state, federal, request for proposals (RFPs)/contract requirements including, but not limited to, documentation desk review, record review, report writing, and follow-up.
- Maintain master-level proficiency on industry standards and federal regulations for Medicaid managed care regulations; provide technical assistance, including presentations of evolving federal regulations to Medicaid managed care plans in an accessible and understandable manner.
- Identify opportunities to improve project processes and procedures, and support quality improvement activities accordingly.
- Monitor and maintain EQRO external and internal information portals, including SFTP site, SharePoint hub, etc.
- Prepare and deliver monthly progress reports to our State contacts.
- Communicate with project partners, clients, subcontractors, and other entities at the direction of the Director/Executive Director.
- Participate in educational opportunities and conferences, as offered.
- Assist with the development, collection, analysis, and reporting of data.
- Project deadlines may necessitate occasional extended work hours.