Santa Clara Family Health Plan
Manager, Health Education
Santa Clara Family Health Plan, San Jose, California, United States, 95199
FLSA Status:
ExemptDepartment:
Quality ImprovementReports To:
Director, Quality and Process Improvement
GENERAL DESCRIPTION OF POSITIONThe Manager of Health Education oversees the day-to-day operations of the Health Education (HE) and cultural & linguistics (C&L) activities at the health plan. This includes oversight and supervision of the Health Education program and services, culturally and linguistically appropriate services, member and staff experience with vendor services, and community education / outreach activities. The Manager of Health Education works cross-functionally to support all projects to improve and reduce health disparities and is responsible for leading and managing the staff who perform those activities.
ESSENTIAL DUTIES AND RESPONSIBILITIES
To perform this job successfully, an individual must be able to perform each essential duty listed below satisfactorily.Develop, implement and manage all HE and C&L processes for continuous and sustained compliance with all applicable state, federal, and NCQA requirements, SCFHP policies and procedures and general business requirements for all lines of business.Develop and track metrics through collecting, analyzing and reporting by appropriate statistical reports related to health outcomes and behaviors to evaluate and improve the HE and C&L program, including the development and implementation of effective, measurable corrective action plans to meet targeted strategic outcomes.Develop policies and procedures to ensure adherence to contractual, legal, regulatory and accreditation requirements.Manage the HE and C&L programs including quality related member outreach activities, health equity projects and activities, assess and approve written health education materials, and other required regulatory submissions.Manage vendors and contractors used for HE and C&L to ensure they perform according to contract compliance and effectively to meet plan needs.Collaborate with internal business units and external providers and community partners to drive quality improvement and health equity projects at the health plan.Conduct literature reviews to inform HE and C&L program development and evaluate evidence-based practices to incorporate into health education.Maintain a thorough knowledge of applicable laws and regulations in order to effectively monitor and ensure compliance with CMS, DHCS, DMHC and other applicable agency and program requirements including NCQA accreditation requirements.Ensure integration of HE and C&L activities into other internal and external teams/departments including delegates, providers, and vendors as applicable.Establish and maintain effective interpersonal relationships with all SCFHP staff, members and/or their authorized representatives, providers and other program or agency representatives.Ensure Quality Improvement and Health Equity Committee preparedness.Attend off site meetings or events as necessary.Perform other related duties as required or assigned.SUPERVISORY/MANAGEMENT RESPONSIBILITIES
Carries out supervisory/management responsibilities in accordance with the organization's policies, procedures, applicable regulations and laws. Responsibilities include:
Recruiting, interviewing, and hiring.Developing a high performing department culture and staff. This includes setting the standard for staff/peers and motivating employees to maximize organizational goals and objectives.Effectively assimilating, training and mentoring staff and (when appropriate), cross training existing staff and initiating retraining. This includes coaching to help increase skills, knowledge and (if applicable) improve performance.Setting goals and planning, assigning, and directing work consistent with said goals. This includes responding to employees' needs, ensuring they have the necessary resources to do their work.Appraising performance, rewarding and disciplining employees, addressing complaints and resolving issues. This includes providing regular and effective feedback to employees and completing timely and objective performance reviews.REQUIREMENTS - Required (R) Desired (D)
The requirements listed below are representative of the knowledge, skill, and/or ability required or desired.
Bachelor's Degree in Health Education or Health Promotion, Health Administration, Public Health, Nursing, or related field; or equivalent experience, training, or coursework. (R)Masters of Public Health Degree in Health Education or Health Promotion. Or Master Certified Health Education Specialist certificate awarded by the national Commission for Health Education Credentialing, Inc. (R)Minimum two years of experience with the duties and responsibilities described above. (R)Minimum two years of work experience with a managed care plan, Medi-Cal and/or Medicare Star programs, hospital, Federally Qualified Health Centers, Indian Health Centers, provider group, Management Services Organization, Independent Physician Associations, health system or clinic. (R)Demonstrated project management and data analysis skills. (R)Strong understanding of quality improvement methodologies. (R)Ability to think creatively and work strategically, to help drive innovative solutions yielding measurable results to the organization. (R)Ability to effectively facilitate meetings and deliver information/presentations to management, regulators, or staff. (R)Strong working knowledge and proficient with Microsoft Office applications, and the ability to operate all applicable software. (R)Excellent oral and written communication skills, including the ability to express oneself clearly and concisely. (R)Ability to effectively facilitate meetings and deliver information/presentations to management, regulators, and staff. (R)Self-directed with ability to assume responsibility, work independently, organize, prioritize, and effectively manage competing initiatives in a fast paced, dynamic environment with a high level of ambiguity. (R)Ability to direct and manage large-scale, complex, cross-functional, multi-departmental projects to completion with minimum supervision. (R)Ability to think creatively and work strategically, to help drive innovative solutions yielding measurable results to the organization. (R)Ability to gather and analyze data, organize and write reports, and organize work efficiently. (R)Ability to take initiative and exercise good judgment when making decisions within the scope of the position. (R)Ability to maintain confidentiality. (R)Ability to travel for in-person offsite conferences, meetings or events. (R)Ability to comply with all SCFHP policies and procedures. (R)Ability to perform the job safely with respect to others, to property, and to individual safety. (R)Maintenance of a valid California driver's license and acceptable driving record, in order to drive to and from offsite meetings or events; or ability to use other means of transportation to attend offsite meetings or events. (R)WORKING CONDITIONS
Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to regular contact with co-workers, managers, external partners, and vendors in person, by telephone and via work-related electronic communications.
PHYSICAL REQUIREMENTS
Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation.
Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies; and sit or stand for extended periods of time. (R)Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds. (R)Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less. (R)Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment. (R)Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone. (R)Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person, by telephone, and electronically throughout a typical workday; attention to detail. (R)
ENVIRONMENTAL CONDITIONSGeneral office conditions. May be exposed to moderate noise levels.
ExemptDepartment:
Quality ImprovementReports To:
Director, Quality and Process Improvement
GENERAL DESCRIPTION OF POSITIONThe Manager of Health Education oversees the day-to-day operations of the Health Education (HE) and cultural & linguistics (C&L) activities at the health plan. This includes oversight and supervision of the Health Education program and services, culturally and linguistically appropriate services, member and staff experience with vendor services, and community education / outreach activities. The Manager of Health Education works cross-functionally to support all projects to improve and reduce health disparities and is responsible for leading and managing the staff who perform those activities.
ESSENTIAL DUTIES AND RESPONSIBILITIES
To perform this job successfully, an individual must be able to perform each essential duty listed below satisfactorily.Develop, implement and manage all HE and C&L processes for continuous and sustained compliance with all applicable state, federal, and NCQA requirements, SCFHP policies and procedures and general business requirements for all lines of business.Develop and track metrics through collecting, analyzing and reporting by appropriate statistical reports related to health outcomes and behaviors to evaluate and improve the HE and C&L program, including the development and implementation of effective, measurable corrective action plans to meet targeted strategic outcomes.Develop policies and procedures to ensure adherence to contractual, legal, regulatory and accreditation requirements.Manage the HE and C&L programs including quality related member outreach activities, health equity projects and activities, assess and approve written health education materials, and other required regulatory submissions.Manage vendors and contractors used for HE and C&L to ensure they perform according to contract compliance and effectively to meet plan needs.Collaborate with internal business units and external providers and community partners to drive quality improvement and health equity projects at the health plan.Conduct literature reviews to inform HE and C&L program development and evaluate evidence-based practices to incorporate into health education.Maintain a thorough knowledge of applicable laws and regulations in order to effectively monitor and ensure compliance with CMS, DHCS, DMHC and other applicable agency and program requirements including NCQA accreditation requirements.Ensure integration of HE and C&L activities into other internal and external teams/departments including delegates, providers, and vendors as applicable.Establish and maintain effective interpersonal relationships with all SCFHP staff, members and/or their authorized representatives, providers and other program or agency representatives.Ensure Quality Improvement and Health Equity Committee preparedness.Attend off site meetings or events as necessary.Perform other related duties as required or assigned.SUPERVISORY/MANAGEMENT RESPONSIBILITIES
Carries out supervisory/management responsibilities in accordance with the organization's policies, procedures, applicable regulations and laws. Responsibilities include:
Recruiting, interviewing, and hiring.Developing a high performing department culture and staff. This includes setting the standard for staff/peers and motivating employees to maximize organizational goals and objectives.Effectively assimilating, training and mentoring staff and (when appropriate), cross training existing staff and initiating retraining. This includes coaching to help increase skills, knowledge and (if applicable) improve performance.Setting goals and planning, assigning, and directing work consistent with said goals. This includes responding to employees' needs, ensuring they have the necessary resources to do their work.Appraising performance, rewarding and disciplining employees, addressing complaints and resolving issues. This includes providing regular and effective feedback to employees and completing timely and objective performance reviews.REQUIREMENTS - Required (R) Desired (D)
The requirements listed below are representative of the knowledge, skill, and/or ability required or desired.
Bachelor's Degree in Health Education or Health Promotion, Health Administration, Public Health, Nursing, or related field; or equivalent experience, training, or coursework. (R)Masters of Public Health Degree in Health Education or Health Promotion. Or Master Certified Health Education Specialist certificate awarded by the national Commission for Health Education Credentialing, Inc. (R)Minimum two years of experience with the duties and responsibilities described above. (R)Minimum two years of work experience with a managed care plan, Medi-Cal and/or Medicare Star programs, hospital, Federally Qualified Health Centers, Indian Health Centers, provider group, Management Services Organization, Independent Physician Associations, health system or clinic. (R)Demonstrated project management and data analysis skills. (R)Strong understanding of quality improvement methodologies. (R)Ability to think creatively and work strategically, to help drive innovative solutions yielding measurable results to the organization. (R)Ability to effectively facilitate meetings and deliver information/presentations to management, regulators, or staff. (R)Strong working knowledge and proficient with Microsoft Office applications, and the ability to operate all applicable software. (R)Excellent oral and written communication skills, including the ability to express oneself clearly and concisely. (R)Ability to effectively facilitate meetings and deliver information/presentations to management, regulators, and staff. (R)Self-directed with ability to assume responsibility, work independently, organize, prioritize, and effectively manage competing initiatives in a fast paced, dynamic environment with a high level of ambiguity. (R)Ability to direct and manage large-scale, complex, cross-functional, multi-departmental projects to completion with minimum supervision. (R)Ability to think creatively and work strategically, to help drive innovative solutions yielding measurable results to the organization. (R)Ability to gather and analyze data, organize and write reports, and organize work efficiently. (R)Ability to take initiative and exercise good judgment when making decisions within the scope of the position. (R)Ability to maintain confidentiality. (R)Ability to travel for in-person offsite conferences, meetings or events. (R)Ability to comply with all SCFHP policies and procedures. (R)Ability to perform the job safely with respect to others, to property, and to individual safety. (R)Maintenance of a valid California driver's license and acceptable driving record, in order to drive to and from offsite meetings or events; or ability to use other means of transportation to attend offsite meetings or events. (R)WORKING CONDITIONS
Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to regular contact with co-workers, managers, external partners, and vendors in person, by telephone and via work-related electronic communications.
PHYSICAL REQUIREMENTS
Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation.
Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies; and sit or stand for extended periods of time. (R)Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds. (R)Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less. (R)Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment. (R)Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone. (R)Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person, by telephone, and electronically throughout a typical workday; attention to detail. (R)
ENVIRONMENTAL CONDITIONSGeneral office conditions. May be exposed to moderate noise levels.