Provider Data Management Program Manager II

Job Summary

Under the general guidance of the Senior Director, the Provider Data Management Program Manager II leads initiatives to organize and coordinate the DMHC Timely Access Report Program and will be responsible for providing strategic guidance, monitoring monthly status and report progress for each team/department accountable for sections of the filing. 

This individual’s primary duties shall include partnering with and oversight of staff of various disciplines to produce results in a timely manner and develop efficient strategies/tactics to ensure that all filing activities deliver a desirable outcome to State regulators. This position will be responsible for organizing and monitoring multi-disciplinary department responsibilities, coordinate cross-functional program activities, develop and control deadlines, activities, apply change, risk, resource management, and resolve scope issues. This position acts as the Business Lead for the Timely Access Report Program to the Department of Managed Health Care (DMHC), resolves complex problems, and works with moderate guidance and direction from the Senior Director. This individual will also initiate and develop strong interpersonal relationships with both internal L.A. Care staff and external business partners in order to facilitate joint decision-making and successful program implementation to support delivery of accurate Timely Access Report submissions to DMHC.

Duties

Critical Thinking & Problem-Solving: Formulate and propose recommended solutions/ options to address moderately complex operational and programmatic challenges in the Timely Access Report Program, with moderate guidance from Senior Director. 

Accountability: Assume ownership under direction of Senior Director, for successful development, planning, and ex+9:9ecution of programs, data reporting, analysis and improvements to infrastructure, from initial concept to implementation stage, with moderate guidance and supervision from Senior Director.

Stakeholder Engagement: Represent L.A. Care and initiate engagement of existing internal and external business partners colleagues, to jointly problem-solve complex member and provider issues.  Facilitate constructive dialogue among internal and external stakeholders to ensure problems are properly assessed, analyzed and resolved, with moderate guidance and supervision from Senior Director.

Relationship building: Establish, foster and maintain strong positive working relationships with internal L.A. Care management staff and external providers and business partners, in order to facilitate mutual collaboration in strategic and operational efforts to improve quality of care and costs, with moderate guidance and supervision from Senior Director.

Program Planning & Implementation: In concert with other departments, work to draft work plans, policies and procedures  that define the program purpose, scope, key milestones and tasks necessary to guide the implementation of program initiatives. Maintain work plan updates to capture any changes that arise throughout the program filing phase. Manage the program team’s progress and performance as it relates to the program tasks; track and report on program status. Identify issues that must be escalated in order to ensure timely completion of program. Manage internal and external meetings, including the development of agendas and objectives. Propose solutions to address and mitigate any anticipated program delays and steer program in positive direction.

Active participation in internal & external initiatives: With moderate guidance and supervision from Senior Director: Serve as L.A. Care business program lead in external stakeholder meetings on behalf of the Provider Data Management team, as required. Serve as L.A. Care business program lead and actively participate in L.A. Care committee standing meetings and management meetings on behalf of the Provider Data Management team, as required. Provide subject matter expertise and input to inform organizational decision making.

Educational Presentations: With moderate guidance and supervision from Senior Director, develop learning objectives, create materials for, and deliver educational presentations in small and large group settings to internal and external non-senior management level audiences, in order to inform and update them on relevant managed care program, product, and policy developments.

Perform other duties as assigned.

Duties Continued

Education Required

Education Preferred

Experience

Required:
At least 5 years of work experience in health care or a related field, conducting root-cause analyses, policy requirements, and managing highly visible organizational programs.

Experience building relationships with organizations and business partners.

Skills

Required:
Knowledge of metric management methodology.

Demonstrated critical thinking, problem solving, and program planning and implementation skills.

Demonstrated strong writing and communication skills.

Demonstrated ability to synthesize and analyze qualitative and/or quantitative data.

Knowledge of regulatory requirements.

Preferred:
Experience working with managing programs or other managerial experience.

Managed care experience.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Additional Information