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 Preadmission Screening and Resident Review (PASRR) contract, 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, Master’s degree, or completion of an accredited nursing program. Completion of an accredited MBA program and/or PMP certification is preferred.
The job requires five (5) years of experience managing operations, preferably in Medicaid-funded healthcare program, mental health, or a related field.
Essential Duties and Responsibilities:
- Supervise a minimum of 6 employees through cultivation of a high performance team-oriented environment that is consistent with the culture and values of Ascend.
- Coordinate all required tasks related to employee schedule changes and time- off.
- Interview and make recommendations for selection of new employees.
- Prepare 30- 45 day orientation plans for new hires.
- Conduct on-the-job training for new employees.
- Coach and counsel employees for success.
- Conduct regularly scheduled 1:1 meetings with direct reports.
- Assist the manager with enhancing contract performance through monitoring and ensuring compliance with contract requirements and Policies & Procedures, communicating all recommendations and actions with the manager.
- Facilitate cross-department collaboration through day-to-day interactions and focused efforts.
- Assist the manager with maintaining a positive customer relationship through ensuring effective communication with customers and employees, assisting with the resolution of customer/provider complaints, and properly documenting relevant customer/provider complaint information.
- Assist the manager with continual process improvement initiatives by monitoring assigned workflow and processes and providing feedback to the manager about ways to refine and optimize them.
- Work collaboratively and effectively with IT to ensure that product and service applications and technologies are optimized for contract compliance, productivity, and quality performance.
- Ensure that all employees and contractors understand and comply with HIPAA and privacy laws while utilizing all Ascend applications and related software/technology.
- Complete quality reviews on Clinical Reviewer, Level I employees, as identified by manager, to ensure Division benchmarks are met.
- Conduct telephonic and document based utilization review that adheres to state directed clinical criteria for determining medical need.
- Associate degree or equivalent combination of education, technical training or work experience considered in lieu of degree.
- Minimum of two (2) years of related experience.
- Ensure compliance with company Wage & Hour policy, including ensuring non-exempt employees get the rest & meal breaks.
- Comply with all company required policies, procedures and processes including but not limited to required training.
- Provides immediate supervision to a unit or group of employees, assigning tasks, checking work at frequent intervals, and maintaining schedules.
- A portion of time is normally spent performing individual tasks related to the unit or sub unit.
- Generally supervises semi-skilled employees or a few individual professional contributors.
- Works on issues of limited scope.
- Follows established practices and procedures in analyzing situations or data from which answers can be readily obtained.
- Monitors daily operations of a unit or sub-unit.
- Requires full knowledge of own area of functional responsibility.
- Frequently interacts with subordinate employees and functional peer groups.
- Interaction normally requires the ability to gain cooperation of others, conducting presentations concerning specific projects or schedules.
- Receives predetermined work assignments that are subject to a moderate level of control and review.
- Directs subordinates to complete assignments using established guidelines, procedures and policies.
- Develop work schedules and assign duties to subordinates to ensure efficiency.
- Evaluate subordinates' job performance and recommend appropriate personnel action.
- Discuss job performance concerns with subordinates to identify causes and issues and works closely with the Human Capital department on resolving problems.
- Identify training needs and development opportunities for subordinates.