Title: QA Manager with Medicaid
Location: Raleigh, NC, United States
Length: Long term
Restriction: W2 or C2C
Interview Type: Skype *** Very long term project; initial PO for 1 year, expect to go for 4+ years *** Remote during covid then onsite
The primary purpose of the Quality Manager (QA Manager) is to coordinate and oversee all program quality functions and oversee all NC Medicaid program reviews. The QA Manager is responsible for assuring program quality standards are developed and implemented and standards are evaluated fairly and consistently. This position verifies all program review deliverables are provided by the timeframes requested and follows up to provide additional information as requested by program reviewers. The Quality Manager is also responsible for working with program staff and management to ensure that all aspects of quality assurance deliverables adhere to and are aligned with state and federal program expectations.
The Quality Manager will be responsible for ensuring that this large, complex program of up to fifteen (15) projects is operating optimally and producing high quality outcomes and deliverables on all levels. This means that the Quality Manager will need to establish systems to monitor and report program performance on both the project and program levels. In order to do so, this role will oversee a team Quality Leads that also drive the development of the program processes, partnering with process owners and other key stakeholders. The Quality Leads will also report on the fifteen different projects in a Quality Dashboard that the Quality Manager will develop.
The Quality Manager is also responsible for developing the Program Maturity Roadmap that outlines the strategic path of program development and enhancement in maturity over multiple years. This Program Maturity Roadmap will also incorporate Agile Transformation leveraging the Scaled Agile Framework (SAFe) methodology, and Scrum as relevant.
QA / Program Review Management
Creating, updating and maintaining quality performance reporting and communicate performance trends to program management.
Identifying trends and overseeing projects to lead continuous improvement and problem-solving efforts to improve quality
Aggregating and analyzing quality data and recommending methods for improving product and service quality, design and/or business processes.
Monitoring, identifying, and analyzing performance metrics in order to provide constructive feedback, maintain high-service levels, and increase production system efficiency.
Coordinating with NC Medicaid PMO and NC Medicaid O&M to ensure all program review findings are identified, tracked. Ensuring a mitigation plan is in place with defined dates for resolution.
Reviewing product history and lessons learned from design validation sources, current production quality, and warranty data to identify and drive preventive measures to ensure optimal quality of each project as it is implemented.
Acting as liaison to federal program reviewers and State and DHHS Project Monitoring Oversight teams.
Following up with management on all exceptions and corrective actions pertaining to quality reviews by staff.
Assisting in determining the States future goals for MITA (technology framework and business processes) by leading meetings with internal stakeholders and vendors to map the Replacement MMIS processes to the "To-Be" MITA 3.0 maturity levels.
Monitoring the CMS Information Technology Systems certification exercise which is heavily reliant on MITA compliance for the technical architecture for deployed IT systems.
Conducting gap analyses of the As-Is operations and To-Be environments to identify appropriate actions needed to reach target program maturity levels
Documenting the program maturity roadmap which maps over time the programs actions to reach target program maturity levels.
Perform crosswalks to evaluate the State Business Process Models (BPM) alignment with or deviation from the CMS-defined MITA BPM.
Ensure the utilization of industry best practices for compliance with CMS and State-defined performance standards.
Additionally, this resource may interface with Division Leadership and other DHHS Subject Matter Experts (SME) as required to complete the work.
Communicating effectively with internal and external clients.
Providing timely communication to project team management on any potential issues.
Communicating and consulting within Division, project stakeholders and within technical community.
Meeting monthly with NC Medicaid PMO and NC Medicaid O&M to review risks and mitigation plans.
Working with leadership to assure that the program is operating in accordance with contract expectations and providing reports and recommendations for sustained or improved quality management.
Communicating clearly goals, processes, and procedures to representatives with varied skill sets (business staff, technicians, managers, etc.).
Using outstanding written communication skills.
Supervision, Organizing and Directing Work:
Providing direction on work activities in accordance with organization goals; monitoring the work of team members to ensure timely, cost-effective completion of work.
Identifying required skill sets by role and development of a skills list for the team. Creating and maintaining a resource plan document that forecasts and plans resource needs for the team and communicating the resource plan to management.
Providing the team with constructive feedback as it pertains to performance; developing and fostering an effective team; and encouraging leadership and professional growth in team members as appropriate.
Developing and maintaining a productive working relationship with external entities, project sponsors, vendors, and other staff.
Supervising and evaluating subordinate staff; motivating team members and facilitating team meetings, identifying and analyzing problems, plans, tasks, and solutions; monitoring team budget (if applicable) and ensuring proper use of assets.
5 years of
Knowledge of Enterprise IT Systems, system integration principles, and associated program, project, and program quality management best practices.
Knowledge of PMI processes, methodology and standards
Knowledge of planning, design and implementation of a Program Quality Management program including the policy, framework and procedures
Demonstrated ability to manage multiple priorities and projects, function in a fast-paced moving constantly changing, deadline driven environment
Proficient use of Microsoft Project, Word, Excel, PowerPoint, Access, and Adobe software
Expert use of process documentation software and process documentation generation. Microsoft Visio is highly desired.
Skills in persuasion, negotiation, relationship management, conflict resolution, and effective oral and written communication at all levels
3 years of Knowledge of Agile principles, processes, and methodology. Scrum and/or SAFe preferred.
3 years of Six Sigma Certification
Nice to have:
3 years of MITA knowledge or experience
3 years of Has an understanding of CMS Seven Standards and Conditions and the Medicaid program