Manager of SoonerSelect Quality

Job Posting Title

Agency

Supervisory Organization

Job Posting End Date

Refer to the date listed at the top of this posting if available. Continuous if date is blank.

Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.

Estimated Appointment End Date (Continuous if Blank)

Full/Part-Time

Job Type

Compensation

Why Youll Love Working Here

At the Oklahoma Health Care Authority (OHCA) your work matters. Every day our team helps ensure Oklahomans have access to better health and better care. Guided by our core values Passion for Purpose Trust & Transparency Empowerment & Accountability Best-in-Class Outcome-Driven and Servant Leadership we foster a workplace where people feel supported respected and empowered to make an impact. Learn more about OHCA.

Lets Talk Benefits

We know your great work deserves great support. Heres a snapshot of what we offer for all eligible employees.

• Generous state-paid benefit allowance to offset insurance premiums.

• A wide selection of insurance plans with no pre-existing condition exclusions.

• 11 paid holidays annually.

• 15 days of vacation and 15 days of sick leave in the first year.

• Longevity Bonus recognizing years of public service.

• Public Service Loan Forgiveness eligibility and tuition reimbursement.

• Wellness benefits including an on-site gym and fitness center discounts.

Job Description

Location: 4345 N Lincoln Blvd Oklahoma City OK 73105

Salary: $74028/year

Work Schedule: Monday Friday

Primary Hours: 8:00 a.m. 5:00 p.m.

Agency/Division Information

The Oklahoma Health Care Authority (OHCA) works to ensure Oklahomans have access to better health and better care. The agencys core values include passion for purpose trust and transparency empowerment and accountability best in class and outcome-driven and servant leadership. As part of the interview process candidates may be required to attend an in-person interview at our Oklahoma City office.

Position Purpose

This position is responsible for the day-to-day operational and technical oversight of quality activities for the SoonerSelect managed care program. The role supports oversight of contracted Managed Care Entities (MCEs) including medical plans the Childrens Specialty Program (CSP) and Dental Benefit Plans (DBPs). Responsibilities include quality report review performance monitoring and analysis Performance Improvement Project (PIP) oversight member and provider experience surveys External Quality Review Organization (EQRO) coordination and contract monitoring and support for the Quality Advisory Committee (QAC) and its subcommittees. The Manager works closely with the SoonerSelect Quality Director to translate quality strategy into consistent monitoring follow-up and measurable improvement.

Essential Functions May Include:

• Manage and coordinate day-to-day quality oversight activities for SoonerSelect MCEs including medical plans CSP and DBPs.

• Conduct detailed reviews of required MCE and DBP quality reports submitted through MCI and other reporting mechanisms; identify deficiencies trends and opportunities for improvement and coordinate follow-up.

• Monitor MCE quality performance using available data sources including MCI CORETechs quality scorecards survey results MCE reports and EQRO findings; identify trends outliers gaps and progress toward established targets.

• Manage and support Performance Improvement Project (PIP) oversight in coordination with the EQRO including review of methodology measures interventions progress barriers outcomes sustainability findings and recommendations.

• Manage CAHPS member experience and Provider Satisfaction Survey activities including coordination with external partners or vendors review and analysis of results reporting identification of trends and development and monitoring of data-driven improvement activities.

• Support oversight and contract monitoring of the EQRO including review of deliverables project activities reports invoices timelines contract performance and follow-up on identified concerns.

• Support the SoonerSelect Quality Advisory Committee (QAC) and its subcommittees by coordinating quality-related materials presenting or supporting presentation of quality data and reports facilitating PIP and quality improvement discussions and tracking recommendations and action items through resolution.

• Serve as a subject matter expert and liaison with MCEs DBPs the EQRO OHCA program areas providers members and other stakeholders regarding quality reporting performance measures PIPs quality improvement expectations and related requirements.

• Prepare analyses summaries reports presentations and recommendations for the SoonerSelect Quality Director Chief Quality Officer agency leadership QAC and other stakeholders; reprioritize work as needed based on emerging quality concerns regulatory requirements leadership priorities and MCE performance.

• Other duties as assigned.

Knowledge Skills Abilities and Competency Requirements:

This position requires strong knowledge of Medicaid managed care quality quality improvement methodologies performance measurement data analysis regulatory and contractual requirements and program oversight. Key skills include data analysis problem-solving report development and team supervision. The role requires the ability to synthesize trends apply regulatory standards communicate effectively with both technical and non-technical audiences critical analysis report review project and contract monitoring stakeholder engagement and clear written and verbal communication. Success in this role is closely tied to the Korn Ferry competencies of Manages Complexity Ensures Accountability and Collaborates which support the ability to lead multifaceted oversight processes hold teams and contractors accountable and coordinate across internal and external partners.

**To be considered for this position your application must include a resume/CV with complete work and education history.**

Education and/or Experience:

• Masters degree and 2 years of professional experience OR

• Bachelors degree and 3 years of professional experience OR

• An equivalent combination of education and experience substituting one year of professional level experience for each year of the required education.

Preference qualifications include:

• Clinical license (e.g. RN LPN LPC LCSW) particularly those with experience evaluating provider performance or quality-related compliance.

• Experience in managed care or Medicaid program administration

• Demonstrated success in stakeholder engagement or vendor management

• Experience in compliance auditing or contract oversight

• Supervisory or leadership experience

• Project or change management certification

• Experience with Medicaid managed care quality quality improvement performance measurement HEDIS/CMS Core Set measures or health care quality reporting

• Experience reviewing Performance Improvement Projects quality reports corrective actions or other formal quality improvement activities

• Experience with External Quality Review Organization activities vendor management contract monitoring or deliverable review

• Experience analyzing health care quality data survey results performance measures trends and outcomes

• Experience engaging managed care entities providers members committees vendors or other internal and external stakeholders

• Supervisory leadership project management or change management experience

• Masters degree clinical license or quality-related certification in a related field

Physical Demands and Work Environment

Work is typically performed in an office setting with climate-controlled settings and exposure to moderate noise the course of performing job duties employees are required to speak stand walk and reach with their hands and arms. This position requires extended periods of sitting and daily use of computers and phones. Employees must be willing to complete all job-related travel associated with this position. Being present at the office is an essential function of this position.

Accommodation Statement

The Oklahoma Health Care Authority complies with applicable State and Federal civil rights laws and does not discriminate. All qualified applicants will receive consideration for employment without regard to race color sex religion disability age national origin or genetic information. If a reasonable accommodation is needed to participate in the job application or interview process to perform essential job functions and/or to receive other benefits and privileges of employment please contact the Civil Rights Coordinator at .

Notice to applicants:

Please add to the address book or safe-senders list in your email. All correspondence will come from this address. Be sure to check your junk folder. If you have questions about the status of your application you can contact the HR team at .

Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.

Current State of Oklahoma employees must apply for open positions internally through Workday Jobs Hub .

Equal Opportunity Employment

The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information race religion color sex age national origin or disability.

Current active State of Oklahoma employees must apply for open positions internally through the Workday Jobs Hub.

If you are needing any extra assistance or have any questions relating to a job you have applied for please click the link below and find the agency for which you applied for additional information:

Required Experience:

Manager