Manager, Risk & Quality Systems (Remote)
About the position Responsibilities • Manage project and/or program managers within the Risk and Quality Systems team to ensure alignment with RQS strategies and goals. • Support annual quality data submissions including NCQA and state regulatory submissions. • Design and develop data-focused strategies to improve data ingestion activities. • Collaborate with Risk & Quality leaders to enhance program performance through meaningful reporting and analytics. • Develop and maintain comprehensive project plans, ensuring timely and high-quality deliverables. • Identify potential risks and develop mitigation strategies for project plans. • Resolve complex problems through project management and stakeholder collaboration. • Conduct regular reviews and audits to maintain performance standards. • Address issues or discrepancies promptly to ensure program success. • Develop data quality strategies to close risk and quality care gaps. • Communicate effectively with stakeholders, reporting risks and issues with recommended solutions. • Prepare and present regular status reports to stakeholders, highlighting progress and risks. • Foster a collaborative and high-performing team environment. • Promote professional development and knowledge sharing within the team. • Mentor team members to develop their professional expertise. Requirements • Bachelor's degree or equivalent combination of education and experience. • 8+ years of program and/or project management experience in risk adjustment and/or quality. • 4-6 years of experience supporting HEDIS engine activity, risk adjustment targeting and reporting systems. • 4-6 years of data analysis experience utilizing technical skillsets to answer risk and quality questions. • People management experience demonstrating excellent leadership skills. • Expertise with running queries in Microsoft Azure or SQL server. • Mastery of Microsoft Office Suite including Excel and Project. • Significant healthcare experience with excellent risk adjustment and/or quality knowledge. • History of partnering with various levels of leadership across complex organizations. • Comprehensive mastery of the drivers of value in managed health care and in-depth knowledge of the healthcare industry. • Expert-level ability to think cross-functionally and identify cost/benefits to stakeholders. • Strong quantitative aptitude and problem-solving skills. • Intellectual agility and ability to simplify complex concepts. • Excellent verbal, written, and presentation capabilities. • Energetic and collaborative personality. • Extensive knowledge of healthcare claim elements. Nice-to-haves • Graduate degree or equivalent combination of education and experience. • Experience in a leadership role within a cross-functional, highly matrixed organization. • SQL mastery. • History of excelling in roles impacting both risk adjustment and quality. • PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification, or comparable coursework. Benefits • Competitive benefits and compensation package. Apply tot his job