Medicare)- Remote

Sentara Health•Norfolk, VA

15d•$38 - $64•Remote

About The Position

Sentara Health Plans is seeking a Manager, Quality Performance and Outreach to play a critical role in driving strategic initiatives to improve STARS, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Performance Withold Program (PWP), and Healthcare Effectiveness Data and Information Set (HEDIS) performance across the health plan and enterprise. This position will focus on CAHPS and Health Outcomes Survey (HOS) for Medicare, and member rewards and data analysis for all lines of business. Reporting directly to the Director, Quality Performance and Outreach, this position leads cross-functional efforts to design, implement, and evaluate outreach and quality improvement programs that enhance member experience, close care gaps, and support regulatory compliance. The position focuses on all lines of business, including Commercial, Medicaid, and Medicare, collaborating with other health plan departments, providers, vendors and the enterprise. The position will manage a team of 3 to 6 direct reports.

Requirements

Bachelor’s degree in Nursing, Clinical Sciences, Population Health, Healthcare Administration, Business Administration, or related field REQUIRED
3 years of experience with HEDIS, STARS, PWP, or Clinical Improvement REQUIRED
3 years of supervisory or management experience REQUIRED
Strong project management and cross-functional collaboration skills REQUIRED
Ability to interpret clinical data and translate insights into actionable strategies REQUIRED
Experience working with vendors and managing outreach campaigns REQUIRED

Nice To Haves

Registered Nurse License in Virginia OR Compact/Multi-state preferred
Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Health Outcomes Survey (HOS) for Medicare experience
Prior experience in Project Management and Performance Improvement highly preferred
Health Plan experience is preferred

Responsibilities

Drive strategic initiatives to improve STARS, CAHPS, PWP, and HEDIS performance.
Focus on CAHPS and HOS for Medicare, and member rewards and data analysis for all lines of business.
Lead cross-functional efforts to design, implement, and evaluate outreach and quality improvement programs.
Enhance member experience, close care gaps, and support regulatory compliance.
Collaborate with other health plan departments, providers, vendors, and the enterprise.
Manage a team of 3 to 6 direct reports.
Manage outreach campaigns.
Interpret clinical data and translate insights into actionable strategies.

Benefits

Medical, Dental, Vision plans
Adoption, Fertility and Surrogacy Reimbursement up to $10,000
Paid Time Off and Sick Leave
Paid Parental & Family Caregiver Leave
Emergency Backup Care
Long-Term, Short-Term Disability, and Critical Illness plans
Life Insurance
401k/403B with Employer Match
Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
Student Debt Pay Down – $10,000
Reimbursement for certifications and free access to complete CEUs and professional development
Pet Insurance
Legal Resources Plan
Annual discretionary bonus if established system and employee eligibility criteria is met.