Shire Jobs

Working Each Day to Make a Difference

At Community Health Plan of Washington, we're driven by our belief that everyone deserves access to quality health care.

More than 25 years ago, we made a commitment to improve the health of our communities by making quality health care accessible to all Washington state residents.

We continue that pledge today by providing affordable comprehensive coverage to more than 315,000 individuals and families throughout the state.

• We are a local not-for-profit health plan in Washington State.
• We are committed to keeping Washington families healthy.
• We connect our communities to the health resources they need.
• We provide access to high-quality care for our members.
• We connect and empower our members through technology.
• The Community Health Centers we partner with strive to support members with a comprehensive mix of medical resources in one convenient location.
• Our partnerships with Community Health Centers and our extended provider network help us improve the health care delivery system.

To learn more about how you can make a difference working at Community Health Plan of Washington, visitwww.chpw.org{rel="nofollow"}.

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*Program Manager II, Risk Adjustment{rel="nofollow"} -- Hybrid, WA *

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[POSITION PURPOSE:]{.underline}

The Risk Adjustment Program Manager II provides project leadership and oversight for vital risk adjustment program activities at CHPW, driving coding projects, supporting vendor relationships, and improving operational outcomes.

[PRINCIPAL DUTIES:]{.underline}

• Develop and maintain detailed project plans to include milestones, tasks, and target/actual dates of completion. Track team adherence to project timelines and clear barriers to team progress, including team conflict.  Escalate risks and impasses to leadership. 
• Lead accurate and complete critical statutory data submissions related to Risk Adjustment.
• Lead the identification of data issues and efforts related to improving data generation and flow throughout the organization, including reporting process and protocol.
• Lead the identification of improvement opportunities in all aspects of risk adjustment, driving improved quality performance. Communicate opportunities to business owners.
• Develop program knowledge to support key strategic opportunities and improvement strategies.
• Communicate regularly with project stakeholders regarding status of the project, issues impeding progress, and recovery plans for off-track items/tasks.
• Establish and maintain effective professional relationships with key upstream and downstream partners

[QUALIFICATIONS:]{.underline}

[Education &]{.underline} [Prior Related Experience]{.underline}:

• Bachelor's degree in business administration, Health Information Management, Healthcare Administration, Analytics, or other relevant academic field, or an equivalent combination of education and highly relevant experience preferred.
• PMP, Agile Professional, or other formal project management certification preferred.
• 3+ year's experience in healthcare program management, preferably related to Risk Adjustment or general healthcare.

[Employment Eligibility:]{.underline}

• Candidate has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency.

* [Knowledge, Skills,]{.underline}*