Quality Improvement Program Manager

Blue Cross of Idaho•Meridian, ID

3d•$78,064 - $117,095

About The Position

The Quality Improvement Program Manager supports quality and clinical improvement efforts across all product lines through cross-functional program coordination, vendor partnerships, and contracting activities. The role organizes and supports workgroups and external partnerships to implement improvements. It also coordinates quality initiatives, vendor-supported programs, and operational solutions; monitors vendor and program performance; and communicates results, risks, and recommendations to leadership and other stakeholders.

Requirements

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

Responsibilities

Collaborate with cross-functional teams, vendors, and business partners to organize workgroups and efforts focused on quality improvement, member outreach, provider support, clinical improvement, and related program activities.
Coordinate vendor and contracting activities for quality programs, including gathering business requirements, supporting requests for proposals or services, contract renewals and amendments, and implementation of 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 improvement opportunity, cost, benefit, resources, and return on investment.
Identify quality and operational improvement opportunities using annual, prospective, vendor, and program data.
Coordinate implementation of 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 and support cross-functional efforts to develop and implement improvement plans and operational solutions across 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.