Clinical Program Manager in Orange at Prospect Medical Systems

Date Posted: 8/9/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    600 City Parkway West
    Orange
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    8/9/2019
  • Job ID:
    13548

Job Description



Clinical Program Manager

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

The Clinical Program Manager (Manager) is responsible for functioning as the implementation, process improvement and optimization lead on all clinical programs and operations. Primary focus will be within the Medical Management organization, with an emphasis on Care@Home, clinical operations, development of new programs to support organizational growth, cost savings and/or revenue generation. The Manager will also be responsible for participation in integration and implementation of Medical Management programs.  Development of the Medical Management eLearning and clinical training university.  In collaboration with the clinical leadership, the goal and objectives are to advance the vision and mission of Prospect Medical Systems, implement and operationalize a sustainable and scalable franchise model of care.  The Manager reports to the Chief Medical Officer, but will work hand in hand with the Directors, Inpatient and Outpatient Case Management, and other Medical Management Leadership.  Collaboratively, s/he will support the organization’s strategic direction, execute and implement defined process improvement initiatives, and support the clinical programs new market expansion efforts.  The Clinical Program Manager will function as the project guide, influencer, manager and lead cross-functional teams through program execution.  S/he works with Clinical Leadership to establish and approve methods for design, development, and implementation of clinical protocols, care management applications/systems, and outcomes reporting. 



Job Responsibilities/Duties

  • Ensure success of Care@Home program by overseeing staff and processes and meeting enrollment, expense, utilization and cost-saving milestones in agreed-upon timeframes
  • In collaboration with executive and business sponsors, lead interdepartmental teams in the implementation, enhancement and optimization of Prospect360 Medical Management Model of Care people, process and systems.
  • In conjunction with the clinical leadership, implement solid clinical operations for new strategic programs, such as Institutional, Hospitalist, Disease Management, Pharmacy and In-home medical care programs with a focus on Medical Management.
  • Manage the continued development of medical management clinical applications and care management platforms, to include, but not limited to; inpatient, outpatient, disease management, pharmacy, and other medical management related technologies.
  • In collaboration with the Medical Management Leaders, develop and implement the Prospect360 eLearning and Clinical Academy training programs, to ensure quality, consistency and compliance. Training programs to include MOC Requirements for SNP, CMC and other lines of business with MOC Requirements. 


Qualifications

Minimum Education: Degree in Business Administration and/or Education Required.

Minimum Experience: Minimum seven (7) years’ experience developing and fully operationalizing medical management programs with an emphasis on chronic/complex care management; deep understanding of managed care, care management, clinical programs and utilization management. Experience in training, clinical applications, and clinical operations in the health care setting. Minimum five (5) years of operations management leadership, within healthcare organizations. Minimum of five (5) years of large-scale program, project implementations, preferably with start-up and/or new revenue generating segments. Minimum of ten (10) years’ experience of working in a managed care, hospital, MSO IPA Operations. Expert knowledge of Medicare, Medicaid, DHS, NCQA, DMHC and other regulatory bodies. Proven track record in developing clinical training programs and clinical learning academies. Excellent oral and written communication skills. Computer literate (proficient in MS Office, Excel, Word). Sound ability to meaningfully assimilate and apply regulatory compliance. Proficient in the development and implementation of policies and procedures and programs. Experienced in Utilization Management auditing processes and corrective actions.

Req. Certification/Licensure: Registered Nurse License Preferred. PMP and/or Lean Six Sigma highly desired.



Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:

  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance

Prospect Medical Systems has a zero-tolerance policy regarding the use of drugs and alcohol.  Our Company is committed to maintaining a productive, drug free workplace that keeps employees and patients safe from harm.  For this reason, we require applicants to pass a screening for drug use as a condition of employment.  This includes: alcohol, marijuana, cocaine, opiates and methamphetamines.



How to Apply

To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www1.eeoc.gov/employers/poster.cfm



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