Job Description
About Our Company
At Altais, we're looking for bold and curious innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, patients, and the clinical community. Doctors today are faced with the reality of spending more time on administrative tasks than caring for patients. Physician burnout and fatigue are an epidemic, and the healthcare experience and quality suffer as a result. At Altais, we’re building breakthrough clinical support tools, technology, and services to let doctors do what they do best: care for people. We invite you to join our growing passionate team as we change the game for the future of healthcare and enable the experience that people need and deserve.
About Your Team
Are you looking to work with a high performing, fast growing and dynamic Clinical Quality team? Altais and our subsidiaries, form one of the most recognized medical groups in California. We are 4,000+ physicians, working in over 40 cities in California, caring for more than 500,000 patients. If working in a mission driven organization supporting highly competent, hard-working, thoughtful clinicians who value good ideas and are passionate about reshaping healthcare excites you, then we are thrilled to welcome you to your new career.
This position is located in our brand-new Oakland City Center location, or remotely (within the state of California). We are flexible provided you are open to traveling to the Oakland office locations as needed.
About Your Work
The Clinical Program Manager II is responsible for leading and participating in multi-departmental and cross-functional committees, supporting quality improvement initiatives, analyzing performance data, and developing improvement activities based on industry best practices. This role requires collaboration with various internal departments and external stakeholders to enhance program delivery and efficiency.
You will focus on:
- Targeted Improvement Activities : Collaborate with team members to develop targeted improvement activities based on current outcome performance and industry best practices aimed at enhancing CMS Star Ratings, HEDIS, CAHPS, HOS, P4P, and other performance measures.
- Research and Integration : Research evidence-based practices, national and regional benchmarks, and industry standards, integrating findings into quality improvement initiatives to ensure alignment with best practices.
- Continuous Monitoring and Feedback : Perform ongoing monitoring of improvement activities through routine analysis of measure outcomes, providing meaningful and actionable feedback to management regarding process enhancement.
- Performance Improvement Methodologies : Effectively utilize and implement performance improvement methodologies to support internal quality initiatives, focusing on rapid-cycle performance improvement for timely and effective results.
- Quality Improvement Program Maintenance : Participate in the development and maintenance of annual quality improvement program documents and evaluations, ensuring the accuracy and relevance of information.
- Training and Development : Support the development, upgrade, and delivery of comprehensive quality improvement training programs and problem-solving methodologies/tools for quality improvement teams and other stakeholders, fostering a culture of continuous improvement.
- Support Intradepartmental Teams : Actively support intradepartmental quality improvement teams, programs, projects, and initiatives, ensuring alignment with organizational goals and objectives.
- Technological Advancement : Continuously seek opportunities to enhance the delivery and efficiency of external-facing quality improvement initiatives through technological advancements and internal process improvements.
- Data Translation and Recommendations : Translate complex data into meaningful information, draw conclusions, and relate findings to industry standards. Provide informed recommendations to departmental stakeholders and the Quality Improvement Leadership Team regarding performance gaps, program implementation, and performance outcomes.
- Report Preparation and Data Analysis : Prepare comprehensive reports, conduct detailed data analysis, and create other materials for presentation to committees and management, ensuring clear communication of findings and recommendations.
- Program and Process Improvements : Actively contribute to the continuous improvement of programs and processes, setting and achieving operational targets within the job area and recommending system/process enhancements to solve problems or improve effectiveness.
- Program Monitoring and Continuous Improvement : Monitor programs from initiation through delivery, ensuring continuous improvement across projects. Partner with business sponsors to define success metrics and criteria, assess and resolve high-priority program risks, and ensure adherence to project methodology compliance standards.
- Stakeholder Briefings and Governance : Serve as a subject matter expert, regularly briefing key stakeholders on various aspects of assigned initiatives. Represent the program in project governance and inter-departmental forums, defining and tracking program milestones while developing, maintaining, and reporting on an integrated delivery plan.
- Operational Targets and Problem Solving : Work to achieve operational targets within the job area, independently managing moderately complex projects/assignments and seeking guidance on higher complexity tasks. Communicate effectively within the department to provide and obtain information, requiring some explanation or interpretation to reach agreement. Provide guidance to entry-level professionals and support employees, ensuring practical knowledge and experience are shared for continuous improvement.
- Committee Participation and Leadership : Lead and actively participate in multi-departmental and cross-functional committees and external stakeholder workgroups, to support key quality improvement initiatives.
- Audit Participation and Process Improvement : Participate in audits as required and contribute to the development and implementation of corrective processes to meet audit requirements and enhance clinical performance, quality, and care management.
The Skills, Experience & Education You Bring
- Bachelor’s degree or equivalent experience. Advanced degree in a related field preferred.
- Minimum 5 years of prior relevant experience in managed care quality improvement, care management or clinical program management in a clinical/healthcare environment.
- Working knowledge of HEDIS, CAHPS, HOS, CMS Medicare Star Ratings, P4P programs, CMS quality withhold, Managed Care Accountability Set (MCAS) and NCQA Quality Improvement standards.
- Managed Service Organization (MSO)/Independent Practice Association (IPA) or Health Plan population health management or quality experience preferred.
- Epic Experience preferred.
- Experience with ICD-10, CPT, CPT II and HCPCs codes preferred.
- Specific licensing requirements may apply (e.g., LVN, RN, NP, PA, MSW, CPhT).
- Agile or Project Management certification preferred.
- Strong analytical and problem-solving skills.
- Effective communication and presentation abilities.
- Strong knowledge of clinical processes.
- Some knowledge of payer, provider, or hospital operations.
- Experience with performance improvement methodologies.
- Ability to translate data into actionable insights.
- Collaboration and teamwork skills.
- Project and program management expertise.
- Skilled in time management to facilitate involvement in multiple projects.
- Excellent organizational skills.
- Must be highly adaptable to changing and challenging situations.
- Strong influencing and negotiating skills.
You Share our Mission & Values
- You are passionate about improving the healthcare experience and want to be part of the Altais mission.
- You are bold and curious - willing to take risks, try new things and be creative.
- You take pride in your work and are accountable for the quality of everything you do, holding yourself and others to a high standard.
- You are compassionate and are known as someone who demonstrates emotional intelligence, considers others when making decisions and always tries to do the right thing.
- You co-create , knowing that we can be better as a team than individuals. You work well with others, collaborating and valuing diversity of thought and perspective.
The anticipated pay range for this role is listed in our salary posting for transparency but may vary based on factors including the candidate’s qualifications, skills, experience, and geographic location. This base pay range is specific to California and can vary based on Bay Area, Metro LA, and Greater California regions which may not be applicable to other locations.
Altais and its subsidiaries and affiliates are committed to protecting the privacy and security of the personal information you provide to us. Please refer to our ‘CPRA Privacy Notice for California Employees and Applicants’ to learn how we collect and process your personal information when you apply for a role with us.
Physical Requirements: Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork – Activity level: Sedentary, frequency most of workday.
Job Tags
Full time, Part time, Remote job, Work from home, Home office, Flexible hours,