Clinical Program Manager III

About Our Company

At Altais, we're looking for bold and curious clinicians and innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, advanced care providers, patients, and the clinical community. At Altais, we're building breakthrough clinical support tools, technology, and services to let doctors do what they do best: care for people. We invite you to join our growing passionate team as we change the game for the future of healthcare and enable the experience that people need and deserve. Altais family of companies include Brown & Toland Physicians, Family Care Specialists and Altais Medical Groups.

About Your Team

Are you looking to work with a high performing, fast growing and dynamic team? We are 4,000+ physicians, working in over 40 cities throughout California, caring for more than 500,000 patients. If you are passionate about reshaping healthcare and want to work for a mission driven organization where new ideas and innovation are valued, then we would like to meet you.

About Your Work

The Clinical Program Manager III is responsible for directing and managing multi-departmental and cross-functional programs and projects, supporting quality improvement initiatives, analyzing performance data, and developing improvement activities based on industry best practices. This role focuses on the development and implementation of departmental or cross-functional team projects or initiatives, ensuring timely delivery and continuous improvements. The Clinical Program Manager III interfaces with internal and external customers on technical matters and program status to enhance delivery and efficiency.

You Will Focus On:

Targeted Improvement Activities: Collaborate with team members to develop targeted improvement activities based on current outcome performance and industry best practices aimed at enhancing CMS Star Ratings, HEDIS, CAHPS, HOS, P4P, and other performance measures.

Research and Integration: Research evidence-based practices, national and regional benchmarks, and industry standards, integrating findings into quality improvement initiatives to ensure alignment with best practices.

Continuous Monitoring and Feedback: Perform ongoing monitoring of improvement activities through routine analysis of measure outcomes, providing meaningful and actionable feedback to management regarding process enhancement.

Performance Improvement Methodologies: Effectively utilize and implement performance improvement methodologies to support internal quality initiatives, focusing on rapid-cycle performance improvement for timely and effective results.

Quality Improvement Program Maintenance: Participate in the development and maintenance of annual quality improvement program documents and evaluations, ensuring the accuracy and relevance of information.

Training and Development: Support the development, upgrade, and delivery of comprehensive quality improvement training programs and problem-solving methodologies/tools for quality improvement teams and other stakeholders, fostering a culture of continuous improvement.

Support Intradepartmental Teams: Actively support intradepartmental quality improvement teams, programs, projects, and initiatives, ensuring alignment with organizational goals and objectives.

Technological Advancement: Continuously seek opportunities to enhance the delivery and efficiency of external-facing quality improvement initiatives through technological advancements and internal process improvements.

Data Translation and Recommendations: Translate complex data into meaningful information, draw conclusions, and relate findings to industry standards. Provide informed recommendations to departmental stakeholders and the Quality Improvement Leadership Team regarding performance gaps, program implementation, and performance outcomes.

Report Preparation and Data Analysis: Prepare comprehensive reports, conduct detailed data analysis, and create other materials for presentation to committees and management, ensuring clear communication of findings and recommendations.

Program and Process Improvements: Actively contribute to the continuous improvement of programs and processes, setting and achieving operational targets within the job area and recommending system/process enhancements to solve problems or improve effectiveness.

Program Monitoring and Continuous Improvement: Monitor programs from initiation through delivery, ensuring continuous improvement. Organize interdepartmental activities to ensure completion within schedule and budget.

Governance and Milestone Tracking: Represent the program in project governance and inter-departmental forums. Define and track program milestones while developing, maintaining, and reporting on an integrated delivery plan, while adhering to methodology compliance standards set by the company.

Operational Targets and Problem Solving: Achieve operational targets with direct impact on departmental results. Independently manage projects under limited supervision, and work to improve processes, systems, or products to enhance job area performance.

Complex Problem Solving: Solve complex problems involving multiple issues or specialties by drawing on prior experience and analysis. Develop new perspectives and approaches to existing problems.

Communication and Influence: Communicate with internal and external parties to provide and obtain information. Influence parties within and outside of the job function at an operational level regarding policies, practices, and procedures. Provide guidance, coaching, and training to other employees and manage projects, delegating and reviewing work as needed. Serve as a subject matter expert, regularly briefing key stakeholders on initiatives.

Committee Participation and Leadership: Lead and actively participate in multi-departmental and cross-functional committees and external stakeholder workgroups, to support key quality improvement initiatives.

Audit Participation and Process Improvement: Participate in audits as required and contribute to the development and implementation of corrective processes to meet audit requirements and enhance clinical performance, quality, and care management.

The Skills, Experience & Education You Bring

• Bachelor's degree or equivalent experience.
• Advanced degree in a related field preferred.
• Minimum 8 years of prior relevant experience in managed care quality improvement, care management or clinical program management in a clinical/healthcare environment
• Managed Service Organization (MSO)/Independent Practice Association (IPA) or Health Plan population health management or quality experience
• Working knowledge of HEDIS, CAHPS, HOS, CMS Medicare Star Ratings, P4P programs, CMS quality withhold, Managed Care Accountability Set (MCAS) and NCQA Quality Improvement standards
• Epic Experience preferred
• Experience with ICD-10, CPT, CPT II and HCPCs codes preferred
• Specific licensing requirements may apply (e.g., LVN, RN, NP, PA, MSW, CPhT)
• Strong Analytical and Problem-Solving Skills: Expertise in analyzing medical records, extracting data, and applying knowledge to improve quality and healthcare outcomes.
• Effective Communication and Presentation Abilities: Excellent verbal and written communication skills, with familiarity in SBAR communication and hybrid work environment preferred.
• Clinical Processes and Healthcare Operations: Strong knowledge of clinical processes and some experience with payer, provider, or hospital operations.
• Performance Improvement Methodologies: Proficient in using project management techniques, tools of continuous improvement, and work process redesign.
• Data Translation and Insight Generation: Ability to translate complex data into meaningful insights and actionable recommendations. Basic computer skills, including proficiency in Outlook and Microsoft Office products and ability to navigate various software programs with instruction.
• Collaboration and Teamwork Skills: Proven ability to collaborate with patients, providers, and internal teams to achieve optimal healthcare outcomes.
• Project and Program Management Expertise: Skilled in managing clinical programs, quality improvement initiatives, and projects, with strong time management skills.
• Organizational Skills: Excellent ability to set priorities, manage multiple projects, and work well under pressure.
• Adaptability: Highly adaptable to changing and challenging situations, demonstrating strong problem-solving and innovative thinking.
• Influencing and Negotiating Skills: Effective at influencing stakeholders and negotiating to achieve desired outcomes.
• Confidentiality and Safety Compliance: Maintains strict confidentiality of client and company information and complies with all safety policies and procedures.

You Share our Mission & Values

• You are passionate about improving the healthcare experience and want to be part of the Altais mission.
• You are bold and curious - willing to take risks, try new things and be creative.
• You take pride in your work and are accountable for the quality of everything you do, holding yourself and others to a high standard.
• You are compassionate and are known as someone who demonstrates emotional intelligence, considers others when making decisions and always tries to do the right thing.
• You co-create, knowing that we can be better as a team than individuals. You work well with others, collaborating and valuing diversity of thought and perspective.
• You build trust with your colleagues and customers by demonstrating that you are someone who values honesty and transparency.

Altais values the contribution each Team Member brings to our organization. Final determination of a successful candidate's starting pay will vary based on several factors, including, but not limited to education and experience within the job or the industry. The pay scale listed for this position is generally for candidates that meet the specified qualifications and requirements listed on this job description. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. We provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.

The anticipated pay range for this role is listed in our salary posting for transparency but may vary based on factors including the candidate's qualifications, skills, experience, and geographic location. This base pay range is specific to California and can vary based on Bay Area, Metro LA, and Greater California regions which may not be applicable to other locations.

Altais and its subsidiaries and affiliates are committed to protecting the privacy and security of the personal information you provide to us. Please refer to our 'CPRA Privacy Notice for California Employees and Applicants' to learn how we collect and process your personal information when you apply for a role with us.

Physical Requirements: Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of workday.

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.