Quality Improvement Program Manager

Blue Cross of Idaho • Meridian, ID

2d

About The Position

Blue Cross of Idaho is hiring a Quality Improvement Program Manager to support quality and clinical improvement efforts across all product lines. The role coordinates cross-functional programs, vendor partnerships, contracting activities, and improvement initiatives. It involves identifying opportunities to improve quality and operations, coordinating approved initiatives, monitoring program and vendor performance, and presenting results and recommendations to leadership and other stakeholders.

Requirements

• Five years of healthcare field experience or relevant experience.
• Bachelor’s degree or equivalent work experience; two years of relevant work experience are equivalent to one year of college.

Responsibilities

• Collaborate with cross-functional teams, vendors, and business partners to organize quality improvement, member outreach, provider support, clinical improvement, and related program workgroups.
• Coordinate vendor and contracting activities for quality programs, including gathering business requirements, supporting requests for proposals or services, handling contract renewals and amendments, and implementing approved services with Procurement and internal stakeholders.
• Monitor quality vendors’ contractual deliverables, service commitments, timelines, issues, and program performance, and coordinate follow-up with internal and external stakeholders.
• Identify, prioritize, sequence, and recommend HEDIS measure improvement initiatives for each line of business, considering potential improvement, cost, benefit, resources, and return on investment.
• Identify quality and operational improvement opportunities using annual, prospective, vendor, and program data.
• Coordinate approved quality initiatives and vendor-supported programs, including workplans, timelines, business requirements, stakeholder coordination, and issue resolution.
• Track program, project, and vendor outcomes and present conclusions, risks, recommendations, and opportunities to leadership.
• Support departmental planning and oversight of vendor services, including contract requirements, renewals, invoices, budgets, and anticipated program needs.
• Coordinate cross-functional efforts to develop and implement improvement plans and operational solutions for applicable lines of business.
• Present program results, analysis, status, risks, and recommendations to management, steering committees, vendors, and impacted work teams.
• Document improvement plans, vendor activities, contractual deliverables, decisions, and program outcomes.
• Perform other duties and responsibilities as assigned.

Benefits

• Paid time off
• Paid holidays
• Community service and self-care days
• Medical, dental, vision, and pharmacy insurance
• 401(k) matching and non-contributory plan
• Life insurance
• Short- and long-term disability
• Education reimbursement
• Employee assistance plan (EAP)
• Adoption assistance program
• Paid family leave program
• Annual incentive bonus, variable depending on company and employee performance

What This Job Offers

• Job Type: Full-time
• Career Level: Manager