Program Manager – Performance and Improvement - Southwestern Health Resources

Southwestern Health Resources; Dallas (TX); Hybride; USD 110 000 - 150 000; Plein temps

Avantages offerts par ce poste

Hybrid Position

Mentorship

Comprehensive training

Leadership resources

Résumé du poste

Southwestern Health Resources is seeking a Program Manager to lead performance improvement initiatives. The role blends analytics, governance, and operations, driving cross-functional teams to improve clinical quality metrics, cost trends, and care delivery efficiency.

The position emphasizes EMR workflow optimization, strategic planning, and pipeline initiatives across CIN networks. A strong PM background and healthcare quality experience are essential for success.

Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Public Health, Nursing, or related field.
• Master's degree preferred in Healthcare Administration, Business Administration, or Public Health.
• 5 years of progressive experience in value-based care, managed care, or quality improvement.
• Experience in an ACO or CIN network; proven multi-disciplinary lead experience.
• PMI PMP, Six Sigma Green Belt, or CPHQ certifications preferred.

Responsabilités

• Performance surveillance: monitor quality metrics and utilization to identify performance drops.
• Governance & root-cause analysis: lead cross-functional workgroups to investigate failures.
• Cross-functional collaboration: partner with Care Management, Pharmacy, and Population Health on interventions.
• Strategy & process improvement: develop a performance roadmap and annual action plans.
• EMR optimization: work with IT/clinical teams to enhance documentation and reporting accuracy.

Connaissances

Performance metrics

Root cause analysis

Cross-functional leadership

EMR workflow

Project management

Data analysis

Formation

Bachelor's degree in Healthcare Administration

Master's degree

Description du poste

Program Manager – Performance and Improvement - Southwestern Health Resources

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

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