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Job Posting Title

Client Quality Manager - Remote

Job Description

The Client Quality Manager ensures the successful development, implementation, execution, and management of quality initiatives, specifically those related to CMS Star and HEDIS measures for assigned health plan clients. This position is also responsible to be a subject matter expert (SME) in the assigned area of focus and serves as clinical liaison for assigned clients. The position requires collaborating cross-functionally with internal and external stakeholders to ensure departmental and client goals are met. The position entails meeting with clients regularly, including health plan leadership, to ensure effective execution of programs. It requires an understanding of the strategic impact of the program(s) for the company and knowledge of how the programs integrate with other clinical initiatives.

Responsibilities

Serve as primary point of contact and subject matter expert on all quality matters pertaining to assigned clients and area of focus.

Lead monthly client meetings, either by phone or in person, to review program reporting and progress, status of strategic plan implementation, and discuss other capabilities, tools, or products that could address issues

Build external client satisfaction by establishing strong client-facing relationships with health plan quality leaders and successfully implementing quality initiatives

Establishes priorities and maintains positive client relationship

Responds to client's requests for information

Assesses, investigates and resolves difficult issues to achieve customer satisfaction

Responsible for oversight of all program reporting

Ensures standard and ad hoc reports are provided accurately and on time

Develops and tracks the appropriate metrics to monitor the quality and impact of the client's program

Provides overall project coordination for the contract's clinical and operational functions.

Collaborate with key internal and external stakeholders, and external vendors, to ensure needs are understood, capabilities are aligned, and initiatives are on schedule and within budget

Develops strong relationships and contacts within the company that are supportive of the achievement of program goals

Works closely with teams to ensure consistent delivery of approved programs to their client

Revenue Generation - Works to ensure revenue goals and administrative expenses are managed

Leads the development of clinical program enhancements and better practices

Identifies program improvement and upsell opportunities

Supports other functions as requested throughout the program lifecycle including contracting, finance, outcomes, communications and IT.

Minimum Qualifications

Bachelor’s degree in business administration or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required

5 years of work experience in managed care or Pharmacy Benefit Management, in client engagement, compliance/regulatory, project management, quality improvement and/or business analysis roles

Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

Comfortable presenting to clients, at conferences, on webinars etc.; either by phone or in person

Proven ability to effectively distill complex information into clear and compelling presentations

Excellent interpersonal skills, with the ability to effectively facilitate meetings, resolve conflict, build consensus, establish rapport and collaborate effectively across departments, internally and externally

Demonstrated ability to identify and lead the implementation of opportunities for enhancements

Organization and prioritization skills, strong attention to detail, and the ability to simultaneously manage multiple projects, under pressure and strict timeframes, without compromising quality

Strong systems aptitude

Excellent client relationship management skills

Ability to work in a high stress environment and manage multiple complex responsibilities

Exceptional verbal and written communication skills

Ability to think through issues and recommend effective solutions

Excellent time-management and multi-tasking skills

Minimum Physical Job Requirements

Ability to travel up to 15% of time

Constantly required to sit, use hands to handle or feel, talk and hear

Frequently required to reach with hands and arms

Occasionally required to stand, walk and stoop, kneel, and crouch

Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds

Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Reporting Structure

Reports to a Senior Director in the Quality Management departmentPotential pay for this position ranges from $94,700.00 - $151,300.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.

Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.

If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email [email protected].