About the Role:

We are seeking a dynamic and experienced Sr. Manager of Process Improvement to support our growing clinical practice in reducing the cost of care and improving patient outcomes for patients living with GI Disease. The Sr. Manager of Process Improvement will report directly to the Sr. Director of Medical Practice and support a multidisciplinary clinical team in developing and executing internal operations and processes to monitor and enhance patient care outcomes while reducing the total cost of care. The Sr. Manager of Process Improvement will work closely with Clinician Leadership, Operational Leadership and the Chief Medical Officer to advance the growing Quality and External Utilization Management programs at Oshi. As a part of a dynamic, fast-paced and quickly growing company, this position will be critical in developing innovative and efficient strategies to scale these pivotal programs.

What you’ll do:

Patient Outcomes

• Supports Clinical Leadership for GI Providers, Registered Dietetics, and Behavioral Health Providers in identifying and measuring meaningful clinical metrics and benchmarks.
• Develops internal processes to assess clinical documentation to ensure compliance with evidence based care and standard of practice.
• Works closely with data and analytics to develop reporting to develop clinical and process metrics and maintains reporting
• Drives logistics, documentation and communication on all quality improvement projects.
• Conducts audits, analyzes quality metrics, and implements Performance Improvement (PI) plans based on patient feedback.

External Utilization Management

• Supports Clinical Leadership in implementing internal processes and clinical workflows that support our clinical principles and reduce unnecessary external utilization.
• Manages and iterates internal tracking and review processes to ensure progress toward internal KPIs
• Supports and manages weekly EUM meetings and ensures clinical consultations are staffed appropriately.
• Incorporates external data feeds such as ADT into internal tracking systems
• Works closely with Data & Analytics and Product/Tech leadership to leverage technology and automated solutions to improve reporting efficiencies

Quality and Patient Experience

• Tracks incoming incident reports and facilitates standard processes for investigation and review
• Trends quality and patient experience data and submits weekly reporting to leadership
• Identifies and investigates trends in data and works with Clinical Leadership to develop process improvement strategies
• Manages weekly meeting series to review incoming incident reports and ensure follow through on investigative findings

Internal Operations

• Maintains accurate and standardized SOPS, job aides, and policies and procedures for the clinical team.
• Maintains accurate and up to date internal documentation.
• Develops SOPS, policies and procedures, and job aides as assigned by Clinical Leadership
• Supports operational efficiency through continuous process improvement
• Maintains internal trackers to ensure efficient communication with legal counsel
• Implements internal process to ensure risk mitigation and compliance with regulatory standards
• Manages third party vendor relationships as needed

Qualities we’re looking for in candidates:

• A deep understanding of care delivery utilizing MDs and APPs across state lines and regulatory requirements at the state and federal level
• Experience with development and oversight of clinical quality programs
• Successful track record of collaborating with legal counsel either internally or externally
• Strong leadership skills to guide and motivate teams
• Skilled in analyzing complex data, identifying trends and developing actionable strategies to address compliance and quality challenges.
• Ability to identify inefficiencies and streamline processes to enhance compliance and quality outcomes.
• Strong collaboration skills to work with cross functional teams including legal, operations, and medical staff.
• Keen attention to detail to ensure accuracy and completeness in compliance documentation and quality reporting.
• Excellent interpersonal skills to build positive relationships with internal and external stakeholders, including regulatory agencies.

What you’ll bring to the team

• Bachelor's degree in a relevant field; Master's degree preferred.
• 5+ years of extensive experience medical practice management, process improvement, clinical quality or external utilization management
• Proven ability to implement efficient and effective internal processes
• Strong leadership and communication skills, with a track record of successful team collaboration and motivation.
• Detail-oriented with excellent analytical and problem-solving abilities.
• Willingness to travel as needed

We take care of our people:

We’re revolutionizing GI care — and our employees are driving the change. We’re a hard-working and fun-loving team, committed to always learning and improving, and dedicated to doing the right thing for our members. To achieve our mission, we invest in our people:

We make healthcare more equitable and accessible:

• Mission-driven organization focused on innovative digestive care
• Thrive on diversity with monthly DEIB discussions, activities, and more
• Virtual-first culture: Work from home anywhere in the US
• Live our core values: Own the outcome, Do the right thing, Be direct and open, Learn and improve, Team, Thrive on diversity
• Competitive compensation and meaningful equity
• Employer-sponsored medical, dental and vision plans
• Access to a “Life Concierge” through Overalls, because we know life happens
• Tailored professional development opportunities to learn and grow

We rest, recharge and re-energize:

• Unlimited paid time off — take what you need, when you need it
• 13 paid company holidays to power down
• Team events, such as virtual cooking classes, games, and more
• Recognition of professional and personal accomplishments