Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

Summary

As a Senior Manager Quality at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve - a community's most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare's biggest challenges. Here are the details on this position.

Your role in our mission

Essential Job Functions

Serves as the SPBM's single point of accountability for population health and quality improvement activities

Works closely with ODM staff to ensure alignment of SPBM population health and QI activities with ODM's population health plan and quality strategy

Develops and manages the SPBM's quality assessment and performance improvement (QAPI) program

Identifies and prioritizes improvement projects to align with ODM's quality strategy

Works closely with ODM-contracted managed care entities, such as MCOs, as directed by ODM to ensure alignment of population health and QI activities in support of ODM's population health plan and quality strategy

Ensures the integration of quality throughout the organization's culture through working with staff from different program areas to identify improvement opportunities, test improvement strategies using proven methods, and assess results using frequent measurements

Ensures appropriate members of the SPBM QI team are fully prepared for QI discussions with ODM

Ensures appropriate SPBM staff are fully prepared for population health and QI discussions with ODM

Increases SPBM staff effectiveness through reinforcing the application of quality improvement tools and methods within SPBM improvement projects and initiatives

Establishes ODM-approved QI onboarding materials and processes for all newly hired SPBM staff and coordinate yearly training in quality improvement principles for all SPBM staff

Ensures sufficient staff to fulfill the requirements of the RFP

Ensures that member and provider perspectives are used to inform quality improvement projects and interventions and to assess the effectiveness thereof

Incorporates the results of quality improvement assessments and evaluations into the SPBM's QAPI

Ensures that clinical and payer best practices are researched and are integrated into all improvement efforts

Shares all that is learned from the improvement projects and initiatives with ODM and ODM[1]contracted managed care entities as directed by ODM

What we're looking for

Basic Qualifications

Bachelor's degree or equivalent combination of education and experience

Master's degree preferred

Five or more years of experience in quality improvement within managed care or PBM pharmacy operations

Five or more years of leadership or supervisory experience

Experience working with quality improvement methodologies in pharmacy (ex. Lean, Six-Sigma, IHI's Model for Improvement)

Demonstrated knowledge of health equity and its evaluation is required

Experience evaluating and benchmarking healthcare quality metrics

Experience in data collection, data interpretation, evaluating intervention outcomes, identifying issues within a population, and evaluating social determinants of health

Other Qualifications

Excellent verbal and written communication skills

Demonstrated leadership ability to set vision, goals and create a positive culture

Drives results

Leads across the organization through influence and collaboration

Approachable and professional in all interactions

Assures employees are trained, coached, evaluated, disciplined and rewarded

Independently generates clear and concise presentations evaluating quality improvement projects and effectively presents them to senior management and customers

Must be efficient using effective time management, be self-motivated, handle multiple tasks simultaneously and switch between tasks quickly

Must be organized and accurate

Must be able to solve problems and make sound decisions without supervision

What you should expect in this role

Work Environment

Work from home; reliable high-speed internet connectivity is required

Employees working-from-home may be asked to travel overnight to Columbus, OH, if needed, to support work efforts. Minimum: quarterly.

The pay range for this position is $105,800.00 - $151,100.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.