Program Manager - Performance and Improvement - Southwestern Health Resources (1/2)

Program Manager – Performance and Improvement - Southwestern Health Resources (1/2) Program Manager – Performance and Improvement - Southwestern Health Resources Southwestern Health Resources is looking for a highly skilled Program Manager. Is that you? Work Hours:Full Time Days (8:00am-5:00pm) for 40 hrs/week (remote work allowed at manager's discretion) Department Highlights: Hybrid Position Gain a sense of accomplishment by contributing to a teamwork environment. Receive excellent mentorship, comprehensive training, and dedicated leadership resources. Contribute and work on a cross functional team What You Will Do: Performance Surveillance & Opportunity Identification

• Metric Monitoring: Continuously monitor performance indicators, including clinical quality metrics (HEDIS/Star Ratings/ACO) or utilization and spend trends (readmissions, ED visits, inpatient days), to proactively identify performance drops or cost spikes.
• Performance Governance & Root-Cause Analysis: Convene and facilitate targeted cross-functional workgroups and performance taskforces, bringing together data analysts and clinical leaders to investigate anomalies and align on systemic operational barriers and solution planning.
• Cross-Functional Collaboration: Directly partner with operational execution teams, such as Care Management, Pharmacy, or Population Health, to present findings, map existing clinical programs against identified performance gaps, and drive cross-functional teams to roll out targeted interventions and performance improvement plans. 30%

Strategy, Process Improvement & Workflow Optimization

• Performance Roadmap & Annual Planning: Lead the development and execution of a comprehensive, tailored annual action plan for each designated performance metric
• Continuous Process Improvement: Partner with clinics and CIN stakeholders to design, implement, and scale sustainable clinical workflows that naturally capture quality metrics or prevent avoidable utilization at the point of care.
• Best Practice Spreading: Identify high-performing clinics within the network, extract their successful operational behaviors (e.g., optimized documentation workflows), and build strategies to spread those practices across the CIN.
• EMR Optimization & Workflow Advocacy: Collaborate with technical and clinical teams to optimize EMR configurations, ensuring that point-of-care alerts, clinical connectors, and documentation templates streamline provider workflows and drive accurate reporting outcomes. 40%

Clinic Education & Strategic Network Initiatives

• Clinical Network Education: Partner with Provider Relations team to translate complex metric goals into actionable, hands-on training and workflows for frontline clinic staff and physicians.
• Patient Outreach & Campaigns: Design and deploy targeted patient outreach initiatives, preventative health screenings, and seasonal clinical campaigns to close true care gaps effectively.
• Payer Reconciliation & Data Integrity: Act as the department's representative for seasonal payer reconciliation audits, ensuring that quality data, utilization metrics, and supplemental data files are accurately captured and reflected in final contract settlements.
• Senior Management Reporting: Author high-level executive summaries, utilization/quality trend variations, and performance trajectory briefs for senior leadership to outline risks and financial opportunities. 30%

What You Need: Education Bachelor's Degree Healthcare Administration, Business Administration, Public Health, Nursing, or a related field Req Master's Degree Healthcare Administration, Business Administration, or Public Health Pref Experience 5 Years 5 years of progressive experience in value-based care, managed care, healthcare quality improvement, or clinical operations Req Experience working within an ACO or CIN network structure; proven track record of successfully managing multi-disciplinary project teams or clinical taskforces Pref Licenses and Certifications PMP - Project Management Professional Certification Upon Hire Pref SSGBC - Six Sigma Green Belt Certification Upon Hire Pref CPHQ - Certified Professional in Healthcare Quality Upon Hire Pref Skills Strong ability to look at macro-level data, recognize performance trends, and operationally investigate root causes and workflow friction points Direct experience tracking and improvement quality and/or utilization metrics Direct experience managing performance metrics across Medicare Advantage, Commercial risk contracts, and ACO models Proven track record of analyzing healthcare metrics to identify business opportunities and facilitating multi-disciplinary stakeholder meetings Strong expertise in process improvement methodologies and a passion for driving patient health outcomes through collaborative, macro-level system changes Diplomatic and stakeholder management skills; ability to lead discussions with separate departments and influence change without having direct authority over their daily execution Clear understanding of value-based care contracts and how quality and utilization metrics directly impact shared savings and financial performance Conceptual understanding of EMR clinical workflows and how documentation accuracy drives final reporting outcomes Project management expertise with the ability to manage multiple complex metric roadmaps simultaneously Proven, hands-on experience designing and executing process improvement projects (e.g., Lean, Six Sigma, PDSA cycles) in an ambulatory clinic, health system, or health plan setting Supervision Individual Contributor ADA Requirements Extreme Heat 1-33% Extreme Cold 1-33% Extreme Swings in Temperature 1-33% Extreme Noise 1-33% Working Outdoors 1-33% Working Indoors 67% or more Mechanical Hazards 1-33% Electrical Hazards 1-33% Explosive Hazards 1-33% Fume/Odor Hazards 1-33% Dust/Mites Hazards 1-33% Chemical Hazards 1-33% Toxic Waste Hazards 1-33% Radiation Hazards 1-33% Wet Hazards 1-33% Heights 1-33% Other Conditions 1-33% Physical Demands Sedentary Travel Requirements Local 20% May travel to clinics around the Dallas Fort Worth metroplex Additional Information Job Field: Clerical/Admin Shift: Day Job Schedule: Full-time #J-18808-Ljbffr Southwestern Health Resources