Qualis - Director of Project Management

Hybrid Position in Little Rock, Arkansas

Qualis represents a diverse set of healthcare providers across four states and their pursuit to drive higher quality healthcare. Qualis is responsible for leading multi-member quality initiatives, developing and sharing best practices for providers, negotiating contracts, and managing the relationship between Qualis and it’s member entities and the insurance payor. This position’s primary responsibility is to track and drive initiatives in pursuit of Qualis’s stated objectives.

1. Partner with the member Revenue Cycle team to design, implement, and maintain an escalation process to identify claims or payment processes needing additional support. Coordinate and improve contract operations process between Qualis teams and payors. Responsible for ensuring all parties are on track with schedules and project deadlines. Maintain documentation and identify/resolve issues as they arise.
2. This position will work closely with legal resources to determine options for escalation.
3. In addition to the escalation process, this position will manage contract timelines and process flows, formal communication with payors, and provider credentialing.
4. This position will research and stay informed of regulatory requirements to aid in payment escalations.
5. The position requires strong problem-solving abilities, great organization, ability to work across the company, and influence both internal and external parties.
6. This position requires the ability to prioritize, adapt, and be comfortable working with tight deadlines with multiple projects occurring simultaneously.
7. This position will be expected to have a high level of communication and technical skills regarding software/systems, as well as the ability to work both independently and with minimal oversight.
8. Above all, this position needs a continuous curiosity, strong work ethic, and desire to create more efficient processes.

ESSENTIAL FUNCTIONS/RESPONSIBILITIES:

1. Punctual and regular attendance.
2. Ability to travel, sometimes overnight, to Qualis meetings and/or Qualis member facilities.
3. Design claim and process escalation process.
4. Manage process flow by gathering documentation and summarizing concerns.
5. Manage provider credentialing.
6. Collaborate with Revenue Cycle teams and legal to set and accomplish goals.
7. Determine contract language changes to combat repeated issues.
8. Create and implement project review process and build status reports for leadership.
9. Research regulatory requirements of the payment process.

QUALIFICATIONS AND EDUCATION REQUIREMENTS

1. Bachelor's degree required with STEM, finance, accounting or Master of Health Administration preferred.
2. At least five years of progressive work experience required; corporate internship/externship will count towards experience.
3. Advanced knowledge of Microsoft Office Suite required.
4. Health care experience preferred.

ADDITIONAL NOTES

1. Must possess a valid driver's license.
2. Must be willing to travel occasionally
3. Must be available for in-person meetings

Job Type: Full-time

Benefits:

1. 401(k)
2. Dental insurance
3. Employee assistance program
4. Flexible spending account
5. Health insurance
6. Health savings account
7. Life insurance
8. Paid time off
9. Vision insurance

Compensation Package:

1. Yearly pay

Schedule:

1. 8 hour shift
2. Monday to Friday

Experience:

1. Medical Project Management: 5 years (Required)

Ability to Commute:

1. Little Rock, AR 72201 (Required)

Work Location: Hybrid remote in Little Rock, AR 72201

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