Maximus’s Clinical Services Division performs a wide array of clinical assessment services for individuals with physical and/or mental disabilities seeking Medicaid-funded services and supports. The Program Manager reports to the Project Director. The Program Manager is accountable for the overall delivery of volume, quality and service level performance targets within the North Carolina Community Alternatives Program for Disabled Adults (CAP/DA) scope, along with developing and monitoring their operational budgets. The Program Manager drives operational excellence for their assigned contracts and will identify, manage, and execute process improvements that yield efficiencies and meet or exceed operational metrics. The Program Manager develops and promotes talent within their assigned contracts as well as drives employee satisfaction, retention and promotions. The Program Manager also leads special projects and initiatives as assigned by the Project Director.
1. Manages day to day operations and performance of assigned contracts including P&L, quality and compliance with terms and conditions along with preparing and analyzing regular performance reports.
2. Manages the customer relationship for assigned contracts ensuring effective and efficient communication along with addressing and resolving customer complaints.
3. Provides leadership and direct supervision to assigned employees, including setting goals, monitoring work performance, coaching and evaluating results to ensure that objectives are met.
4. Regularly interacts with senior management or executive levels on matters concerning assigned contracts.
5. Participates in continual process improvement by monitoring, refining, and optimizing staffing, assignments, workflow and processes.
6. Creates an effective work environment by involvement in developing and hiring superior talent and instilling a culture of accountability, measurability and discipline.
7. Participates in developing, modifying and executing company policies that affect operations and may also have organization-wide effects.
8. Works collaboratively and effectively with IT to ensure that product and service applications and technologies are optimized for assigned contract compliance, productivity, and quality performance.
9. Performs other duties, as necessary.
• Maintains primary responsibility for ensuring customer satisfaction, resolving compliance issues, accountability for profit & loss and adherence to operational budgets with assigned contracts.
Knowledge, Skills & Abilities
• Ability to lead and manage day to day operations and drive continuous improvement
• Strong project management skills and/or aptitude
• Ability to work effectively in a “hands-on” management role, motivating staff through variety of communications vehicles
• Ability to document and re-engineer business processes
• Ability to create and direct a ‘daily management plan’ for all contracts
• Outstanding work ethic, integrity, and value system
• Excellent analytical and complex reasoning skills
• Ability to perform all job duties in compliance with Person First standards, HIPAA guidelines, and company confidentiality policies
• Ability to multitask effectively while performing job duties, including ability to prioritize tasks and ensuring all voice mail and email messages are returned within six business hours of receipt
• Strong organizational, supervisory and interpersonal skills
• Outstanding written and verbal communication skills
• Ability to interact professionally and collegially with referral sources (hospital & nursing home staff, physicians, social service workers, etc.), state contract officers, and coworkers
• Advanced skill with word processing, spreadsheet, presentation, and publishing software (Microsoft Word, Excel, PowerPoint, Publisher, and Visio strongly preferred)
The job requires a Bachelor’s degree; completion of an accredited MBA program and/or PMP certification, or Registered Nurse licensed in North Carolina preferred.
The job requires five (5) years of experience managing operations, preferably in Medicaid-funded healthcare programs, mental health, or a related field.
Essential Duties and Responsibilities:
- Serve as the lead content knowledge expert concerning the review and research of provided medical information.
- Perform medical case reviews consisting of medical referral information to facilitate appointing by Lay- Staff.
- Facilitate the provision of coaching for Lay- Staff in assisting patients with scheduling care.
- Identify and direct the provision of Medical Terminology training to Lay- Staff for scheduling and specialty referral appointing.
- Assist in providing organizational support of ICD- 10 coding of medical documentation.
- Maintain professional nursing oversight documentation on staff and assure compliance with licensure and training.
- Provide manager with updates on all issues regarding quality, training, policy, procedures, staff issues, case determination and appeals activity.
- Provide supervision, development, and coaching of staff to assure quality, productivity, attendance and timeliness of work completion and departmental goals.
- Establish work procedures and standards to improve efficiency and effectiveness of assigned operations.
- Compose performance evaluations for bonuses and annual focal point reviews.
- Provide training and disciplinary action in accordance to company and project guidelines.
- Complete and deliver performance warnings as applicable.
- Maintain effective interdepartmental relationships.
- Facilitate meetings as needed.
- Interview and recommend applicants for hire.
- Monitor workload and coordinate schedules.
- Communicate pertinent program updates in a timely manner using ability to review and understand contract scope and requirements.
- Perform other duties as may be assigned.
- Manage, perhaps through subordinate supervisors, the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.
- In some instances this manager may be responsible for a functional area and not have any subordinate employees.
- Work on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends.
- Follow processes and operational policies in selecting methods and techniques for obtaining solutions.
- Act as advisor to subordinate(s) to meet schedules and/or resolve problems.
- Develop and administer schedules, performance requirements; may have budget responsibilities.
- Frequent interaction with subordinate employees, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers and the company.
- Often must lead a cooperative effort among members of a project team.
- Receive assignments in the form of objectives and determine how to use resources to meet schedules and goals.
- Provide guidance to subordinates within the latitude of established company policies.
- Recommend changes to policies and establish procedures that affect immediate organization(s).