Public Consulting Group

Program Manager - Healthcare QA

Job Locations US-NY-Albany | US-NY-Buffalo | US-NJ-Newark | US-MA-Boston
Posted Date 1 month ago(6/22/2021 8:53 AM)
Job ID
2021-6761
# of Openings
1
Category
Process and Analytics
Type
Regular Full-Time
Practice Area
Health Services

Overview

About Public Consulting Group

 

Public Consulting Group, Inc. (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986 and headquartered in Boston, Massachusetts, PCG has over 2,500 professionals in more than 60 offices worldwide. PCG’s Health practice offers in-depth programmatic knowledge and regulatory expertise to help state and municipal health agencies respond to regulatory change, improve access to health care, maximize program revenue, improve business processes, and achieve regulatory compliance. Using industry best practices, PCG’s Health team helps organizations deliver quality services with constrained resources to promote improved client outcomes. To learn more, visit http://www.publicconsultinggroup.com/health/.

Responsibilities

The Health Care Financing Solutions team is looking for a Consultant interested in Project Management to join the team!  The Health Care Financing Solutions unit provides reimbursement and claim solution services to state and local governments.  Specific reimbursements services include Rate Setting, Cost Reporting and Cost Settlement.  Claiming solution services included: TPA/ASO operations, Coding and Compliance services as well as Provider Billing Services.

 

Overall Responsibilities:

This position occupies a critical role in PCG and are key in achieving business objectives of one specific multi-year project. Working with the case management team and claims team, the ideal candidate will be able to work with clinical and operational staff to ensure compliance with contractual and regulatory responsibilities. The candidate will be a central organizing figure for the PCG team and will interface heavily with our client. Background working with case management services is preferred, but not mandatory.

 

Specific job responsibilities include:

  • Serves as project management lead and primary client point of contact for large-scale engagement.
  • Coordinates with more than a dozen PCG staff and tasks with limited supervision while meeting and exceeding performance expectations.
  • Exceptional communication and organizational skills. Ability to monitor progress on many overlapping tasks and deadlines.
  • Facilitates client discussions.
  • Delegates tasks and responsibilities to team members.
  • Manages daily project functions and client interaction.
  • Evaluates programs and makes recommendations for improvements.
  • Analyzes and interprets federal and state law and regulation.
  • Assesses best practices and provide technical assistance to clients.
  • Leads proposal writing teams, including writing sections, coordinating efforts, and preparing proposal submissions.
  • Prepares other written reports and materials for clients
  • Ability to understand both the service delivery system for programs which are administered by states and monitored by federal regulators.
  • Ability to understand and be an expert in complex federal regulations and requirements.
  • Strong Microsoft Office applications skills, especially data analytics (i.e. ACCESS, SQL, SPSS)
  • Ability to use sound judgment in completing tasks and to seek guidance when needed.
  • Attention to detail and ability to work with large data sets with accurate results.
  • Ability to move projects forward within a specific timeline and budget while working at a detailed level.
  • Commitment to exceptional client service.
  • Creative problem-solving ability and a consultancy mindset.
  • Dedication to accomplishing goals and challenges presented by clients and management.
  • Ability to interact with various levels of management and with clients.
  • Flexible, self-starter possessing intellectual curiosity.
  • Enthusiasm for life-long learning and staying well-informed about current business issues.
  • Able to follow, critically evaluate, and improve upon current processes. Reviews business operations for service and efficiency improvements.
  • Excellent business writing skills and ability to make presentations to various audiences.
  • Ability to recognize issues and identify solutions.
  • Responsible for monitoring and updating policies and procedures to include regulatory changes.
  • Identifies deficiencies by conducting regular analysis of Case Management services
  • Ensures that Clinical Assessment Services is meeting key metrics including efficiency, effectiveness and SLAs. Involves accessing regular report metrics and managing to needs of the team.
  • Effectively analyzes processes and implements innovative ideas to improve efficiencies of the Medical Indemnity Fund
  • Reviews performance of the clinical team to meet, or exceed, the department standards for Productivity and Quality while continuously looking for process and quality improvement opportunities.
  • Works closely with the Manager of Case Management to assure that the Quality Assurance Programs for Assessment Services is sufficient to meet customer and program needs

 

Qualifications

Education: Bachelor's degree and Master's degree or 5 years' Health Care experience required.  Master's degree (MPA or government focused MBA) preferred.

 

Experience: 5+years of relevant work experience

 

 

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EEO Statement

Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.

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