American Specialty Health Incorporated is seeking a Manager-Health Services to join our Health Services (HLS) department. This position will provide management support for administrative and projects to the Associate Director, Health Services and Associate Vice President (AVP) Health Services and for the Health Services Department (HLS) teams and to assist with quality improvement functions, accreditation and delegation, meeting management, projects, committee support functions and quality assurance.

Remote Worker Considerations

Candidates who are selected for this position will be trained remotely and must be able to work from home in a designated work area with company-provided technology equipment. This remote/WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network (minimum internet download of 50 Mbps and 10 Mbps upload speed).

Salary Range

American Specialty Health complies with state and federal wage and hour laws and compensation depends upon candidate’s qualifications, education, skill set, years of experience, and internal equity. $56,700 to $70,000 Full Time Annual Salary Range.

Responsibilities

• Supports Associate Director, Health Services and AVP/ Health Services, and departmental/ inter-departmental initiatives related to primary functional areas including Project Management, Health Quality Assurance, Quality Improvement initiatives, accreditation, delegation, and other clinical/operational committee management.
• Provides administrative and project support to the Assoc. Director, Health Services, and AVP Health Services as needed.
• Contributes to teamwork in achieving the objectives and goals of corporate priorities, product development, special projects, and daily tasks.
• Supports the Quality Improvement process for all ASH Lines of Business which includes the QI WorkPlan, QI Annual Evaluation, QI Dashboards, Quality Improvement Activities, QI Studies, provides quarterly, and annual reporting.
• Assist in the preparation of HLS and quality improvement reports, quarterly BOD reports, QAC Chair Reports, QI Quarterly Dashboards, sentinel and clinical QA reports, and others as assigned by Assoc. Director, HLS.
• Leads and provides project support for ASH accreditations and delegation requirements under the direction of the Assoc. Director, HLS, AVP Health Services and HLS manager. Develops compliance crosswalks, assesses standards, collects compliance evidence, bookmarks, highlights, and notates call outs within compliance documentation.
• Coordinates meetings with business owners, and key individuals to explain accreditation programs, interprets standards, and provides guidance to business owners on the collection and identification of appropriate compliance evidence.
• Manage and maintain SharePoint databases for Accreditation and Quality including Accreditation/Delegation Quality (ADQ) SharePoint database, ASH Quality Improvement, and Health Services Quality. Provide expertise in creating and updating SharePoint sites for accreditation documentation and interact with IT, Coaching and Business owners.
• Oversees the QI Monitoring Forms for the QI Work Plan activities; provide quarterly updates with input from Business Owners; identify missed metrics and assist with the escalation process (analyzing metrics for root causes, take action to resolve issues).
• Provides committee support for QAC (HM), QAC Policy Workgroup,), QA Team A, and Evidence Evaluation Committees, and other workgroups and teams as assigned (Team meeting logistics, agendas, minutes, action logs, follow-up on actions with business owners to closure and identifying QI opportunities).
• Develop databases, create ad hoc reports, and provide analyses of data as needed to support HLS functions.
• Quality support of the QA process for coaching, collaborating with QA Team A, Director of Nursing, Medical Directors, and nurses. Develop and update of case submission forms, databases, and reporting of monthly/quarterly and annual results by product. Manage Emergency Occurrence QA Case Submission Reporting tool, develop and update case submission forms, support the database and reporting process.
• Support the Escalation process for missed metrics, including notification, follow-up, and reporting, and closing escalations, reporting to the Quality Oversight committees.
• Support the Policy Work Group process by collaborating with business owners and the policy team to track, monitor, and update policies, including Health Information Resources requiring external expert review, as recommended by the committee and accreditation and regulatory compliance. Provide follow-up as required to ensure closure of action items.
• QI/QA Compliance across the company with focus on QA HLS quality, accreditation, delegation, and the member QA process. Create charts, fishbone diagrams and utilize other quality tools to assist with QI/QA compliance.
• Assist with QA/ QI projects and facilitate activities assigned to ASH teams and committees on the QI Work Plan.
• Develop charts and graphs to show and analyze trends for ASH functions.
• Team and organizational training – Develop presentations/trainings as needed utilizing PowerPoint and LMS, provide scripting, recording of training, editing, create quizzes. Working across the company to obtain input, content, and approval of training programs. Coordinate trainings with HR and IT.
• Support the development, collection of data, analysis, and reporting for the Annual QI Evaluation and QI Work Plans for all Lines of Business. Identify opportunities for improvement and recommendations for the next QI year.
• Support the accreditation program assessment process including developing readiness surveys to all business owners, gap analysis and standards review.
• Support delegation oversight of vendors (product quality and biometrics screening).
• Provide administrative and data support of the Quality SharePoint site, including developing pages, formatting, providing views and lists, and providing reports.
• Identifies and manages QI projects and process improvement opportunities utilizing DMAIC methodology (define, measure, analyze, improve and control); create surveys, obtain data, conduct root cause analyses, develop value stream maps, and use other QI tools to present and distribute results.
• Accreditation project management to assess organizational readiness develops compliance grids, identify GAPs, and develop a project plan to support the accreditation process.
• Support quality training initiatives and programs in the development of course material, presentations, scripting, recording, and presenting topics as assigned.
• Documents procedures develops workflows and job aids for all functions/responsibilities within scope of job.
• Coordinates vendor delegation and quality oversight. Works collaboratively with Health Management Operations in assuring biometric screening and immunization services are carried out at a high level of quality service to members.
• Supports the annual policy review process with policy team and consulting vendors, and external consultants/ for Health Information Resources including documenting edits, processing invoices, and collaborating documentation with HLS Policy Team.
• Quality Improvement Studies/QIA facilitation, development, research, quality initiatives, work with Business Owners to remain on target, set new goals, manage annual recommendation summaries and additional follow-up.
• Admin Support for ASH and Health Services.
• Coordinate arrangements for off-site meetings and audits, checking availability of participants, scheduling teams, and setting up conference logistics with external participants (as applicable).
• Other tasks as assigned by management to support ASH and future project development, research, identifying efficiencies, develop tools and update processes as needed.

Qualifications

• Bachelor’s Degree in Health Care field, health information, business, quality management or equivalent degree required.
• Minimum 3-5 years health care, health care administration or business; and experience with quality improvement/program coordination preferred.
• Certification in Healthcare Quality (Certified Professional in Healthcare Quality, CHCQM, or equivalent) highly preferred.
• Experience with committee facilitation and minute-taking highly preferred.
• Experience planning, developing, coordinating, and guiding projects from inception through implementation.
• Experience working in wellness, health care, disease management, or health plan programs preferred.
• Experience with SharePoint applications; building pages, editing, linking, and managing SharePoint pages
• Experience with reporting, document management and data entry required Demonstrated writing proficiency and strong verbal and written communication skills required.
• Excellent organizational and prioritization skills, with the ability to multi-task
• Computer proficiency in MS Word, Excel, Visio, Forms, Teams, and PowerPoint
• Experience with health care language and terminology through academic and practical preparation preferred.
• Minimum 2 – 5 years working knowledge of accreditation standards (URAC, NCQA, JCAHO, etc.) highly preferred.
• Strong writing, editing and analytical skills.
• Minimum 2 – 5 years working knowledge and understanding of quality principals and concepts (Six Sigma, LEAN, or other) with demonstrated critical thinking capabilities
• Ability to develop, interpret and analyze reports and measurement criteria.
• Strong desire to learn and participate in a team environment.
• Demonstrated use of Microsoft Project or other project management tools to manage, track and complete assigned projects.

Core Competencies

• Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
• Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
• Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
• Ability to effectively organize, prioritize, multi-task and manage time.
• Demonstrated accuracy and productivity in a changing environment with constant interruptions.
• Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
• Ability to exercise strict confidentiality in all matters.

Mobility

Primarily sedentary, able to sit for long periods of time.

Physical Requirements

Ability to speak, see and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Work remotely from home. Ability to travel within the facility, upon request. On limited occasions in support of accreditation, travel to other ASH offices. Capable of using a telephone and computer keyboard. Ability to lift up to 10 lbs.

Environmental Conditions

Work-from-home (WFH) environment.

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law.

Please view Equal Employment Opportunity Posters provided by OFCCP here.

If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company’s legal duty to furnish information.
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