Santa Clara Family Health Plan Hiring for Operations Project Manager Job at San Jose, CA Full Time

Santa Clara Family Health Plan (SCFHP) is a local, community-based health plan dedicated to improving the health and well-being of the residents of Santa Clara County. Working in partnership with providers and community organizations, we serve our neighbors through our Medi-Cal and Cal MediConnect (Medicare-Medicaid Plan) health insurance plans.

About the role:

The Operations Project Manager is responsible for supporting health plan initiatives by leading the analysis and implementation of medium to large-scale projects and efforts, and support vendor contracting. The Operations Project Manager works collaboratively and cross-functionally with internal and external stakeholders, including consultants, auditors and providers to improve health plan operations at Santa Clara Family Health Plan (SCFHP). The Operations Project Manager is responsible for developing work plans, gap analyses and facilitating stakeholder collaboration for all projects assigned, including ongoing program planning for annual benefit designs for all applicable product lines. In addition, the position will work cross-functionally with departmental subject matter experts to facilitate vendor contracting and ongoing management to ensure compliance with SCFHP language requirements, processes and service level agreements.

Day to Day:

• Lead and facilitate medium to large-scale projects by providing direction for project framing, organization, business case analysis, implementation, and outcome/success measurement.
• Assist in developing policies and procedures across the organization.
• Support and coordinate business change initiatives and activities associated with operational improvements to ensure smooth transitions for stakeholders.
• Create, monitor and execute project work plans and deliverables and communicate the status of existing projects with Operations Management.
• Develop and maintain all appropriate project documentation, including timelines, project scope, decision logs and work plans. This includes development of process documents including, process maps, workflows, and desktop procedures.
• Monitor timeliness of projects, cost management, and resource usage to ensure completion and implementation of project and budget variances.
• Identify, research, and resolve project issues and escalate critical issues, problems, and delays to management and executive leadership, as needed.
• Conduct studies of operations, workflows, and fact gathering sessions with stakeholders to document, quantify, and specify business needs and improvement efforts. Work with internal stakeholders and business leaders to identify the gap between current and desired results.
• Analyze data in support of operations projects and collaborate with IT for data collection and/or report development, as needed.
• Manage specific vendor relationships as assigned, fostering positive relationships, and monitoring performance against performance standards.
• Understand and track applicable regulatory requirements. Document and report project results to Plan Management, DHCS, DMHC and CMS, as needed.

About You:

• Bachelor’s Degree in Management, Business, Healthcare, or a related field, or equivalent experience.
• Minimum two years of project management experience.
• Ability to effectively facilitate meetings and deliver information/presentations.
• Experience with health care program evaluation, design, and implementation
• Knowledge of regulatory requirements for Medicaid, Medicare, and accreditation standards.
• Ability to organize, plan, direct and manage medium to large scale, complex, cross-functional, multi-departmental projects.

Please review the full job description and apply on our Career page: hhttps://phf.tbe.taleo.net/phf04/ats/careers/v2/viewRequisition?org=SANTCLAR2&cws=38&rid=2831

Job Type: Full-time

Pay: $99,315.00 – $153,938.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Tuition reimbursement
• Vision insurance

Schedule:

• Monday to Friday

Ability to commute/relocate:

• San Jose, CA 95119: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• Do you have experience with healthcare program evaluation, design, and implementation?

Education:

• Bachelor’s (Preferred)

Experience:

• Project Management: 2 years (Preferred)

Work Location: One location