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"}.

* *

Program Manager II, Quality Data Operations

* *

[POSITION PURPOSE:]{.underline}

The Program Manager II, Quality Data Operations is responsible for overseeing the Healthcare Effectiveness Data Information Set (HEDIS), Consumer Assessment of Healthcare Providers (CAHPS), Qualified Health Plan (QHP), and Health Outcomes Survey (HOS) programs' data collection, reporting and analytics. This includes annual audits and statutory data submissions for the associated state and federal programs. The role involves developing and maintaining project plans, tracking timelines, facilitating accurate and timely data submissions, and clearing barriers to team progress. The Program Manager II is also responsible for identifying and triaging data issues, identifying and driving data quality measurement opportunities, and maintaining effective communication with internal and external stakeholders, including managing contracted vendor performance, and evaluating new vendor opportunities. The Program Manager II collaborates with various departments to enhance operational readiness and performance measurement, while also providing status reporting and communications to various levels of leadership.* *

[PRINCIPAL DUTIES:]{.underline}

Serve as a subject matter expert for HEDIS, Prospective Medical Record Review (PMRR), CAHPS (Medicaid & Medicare), QHP, and HOS program management for annual audits. Work directly with internal teams, third-party auditors, and vendors to ensure projects meet goals and objectives. Provide expert guidance on compliance and quality standards and address any issues that arise during audits to ensure successful outcomes.

Develop, implement, lead, and manage projects and data-driven initiatives to improve HEDIS, PMRR, Medicaid CAHPS (Adult & CCC), Medicare CAHPS, QHP, and HOS. Assign team responsibilities, collaborate with project stakeholders, and ensure appropriate internal resources are allocated.

Develop and maintain detailed project plans including milestones, tasks, and target/actual dates of completion. Set SMART goals, allocate resources effectively, and ensure timely execution. Track team adherence to project timelines and clear barriers to team progress, including team conflict. Escalate risks and propose mitigation strategies to leadership. 

Lead the end-to-end processes of data submission to regulatory bodies ensuring accurate and complete critical statutory data (HEDIS, CAHPS, QHP & HOS)