Manager, HRA Team

Who we are

Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.

Our commitment is to:

• Strive to apply an equity lens to all our work. 
• Reduce health disparities. 
• Become an anti-racist organization 
• Create an equitable work environment. 

About the Role

Provides administrative and operational leadership to the Health Risk Assessment (HRA) team. Responsible for oversight of the HRA program and staff to maximize completion rates and ensure members are appropriately connected to internal care management programs.

Essential functions and Roles and Responsibilities:

• Responsible for the management and daily operations of the HRA team, including staffing and scheduling, to ensure that member outreach is effective and completed within defined timeframes and according to established processes.
• Ensures that team members are adequately trained to achieve member engagement targets and defined clinical and financial outcomes. This includes onboarding new staff and ongoing training for existing staff.
• Prioritizes daily workflows, assignments, and triage priorities to meet state and Federal regulatory requirements and established organizational performance metrics.
• Monitors the performance and productivity of team and team members to ensure guidelines are followed and goals are met.
• Facilitates collaboration with internal partners for a coordinated approach to HRA completion for members.
• Implements changes with other multidisciplinary team managers to effectively drive continual process improvement.
• Collaborates with leadership to establish efficiency and quality standards for the team; implements workflows to achieve assigned metrics.
• Assists leadership in the identification, implementation, and maintenance of standardized operations to ensure compliance standards are met.
• Reviews quality audits and shares results with associates in a timely manner; provides education and coaching to improve performance as needed.
• Assists in performing direct member outreach as needed to support staff and the team.
• Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion.

Knowledge, Skills, and Abilities:

• Ability to set performance expectations, coach for performance success, and achieve department and company objectives.
• Knowledge of CMS Medicare care management, and special needs plan (SNP) requirements.
• Proficient verbal and written communication skills.
• Proficient organizational and time management skills
• Knowledge of regulatory and certification requirements and their impact on the organization such as Healthcare Effectiveness Data and Information Set (HEDIS), Consumer Assessment of Healthcare Providers & Systems (CAHPS), and National Committee for Quality Assurance (NCQA).
• In depth knowledge and understanding of health plan benefits and Medicare regulatory requirements.

As part of our hiring process, the following criteria must be met:

• Complete and successfully pass a criminal background check.

Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant’s criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees.

• Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency.
• Vaccination requirement (CHPW offers a process for medical or religious exemptions)
• Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation.

Compensation and Benefits:

The position is FLSA Exempt and is not eligible for overtime. Based on market data, this position grade is 68E and has a 10% annual incentive target based on company, department, and individual performance goals.

CHPW offers the following benefits for Full and Part-time employees and their dependents:

•  Medical, Prescription, Dental, and Vision
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