Quality Improvement Program Manager - St. Luke's Health Plan
About The Position
The QI (Quality Improvement) Program Manager is responsible for optimizing the Health Plan's quality improvement program, including HEDIS and member experience surveys, such as CAHPS. Works closely with cross-functional teams to optimize HEDIS measures and manage quality improvement projects. What You Can Expect: Build and document processes and workflows for a newly established Quality department, including standard procedures for HEDIS, CAHPS, and QI activities. Coordinate assigned work across teams and vendors by tracking tasks, confirming data accuracy, and escalating issues when needed. Manage multiple QI projects at the same time, organizing work, meeting deadlines, and supporting day-to-day execution in a fast-moving environment. Support HEDIS and accreditation tasks by executing processes to meet QI accreditation standards, maintaining documentation, preparing required materials, ensuring accurate and timely reporting, and facilitate audit processes.
Requirements
- Bachelor's degree or experience in lieu of
- 4 years of relevant experience
Responsibilities
- Collaborate with Information Health Technology (IHT) and vendor teams to ensure accurate and timely data collection and reporting.
- Monitor, analyze, and prioritize HEDIS and CAHPS data.
- Utilize data analytics and performance metrics to identify areas for improvement using annual and prospective data.
- Propose new quality improvement programs.
- Develop and support implementation of approved programs, setting clear goals and objectives.
- Organize cross-functional efforts to optimize current programs and execute new programs targeted at Health Plan quality improvement.
- Maintain comprehensive documentation and accurate records of quality improvement initiatives, programs, activities, and outcomes.
- Present results of quality improvement programs on targeted HEDIS measures to management and impacted teams.
- Ensure compliance with healthcare regulations and accreditation standards, such as NCQA, HEDIS, and CMS.
- Stay updated on changes in HEDIS and PQA measures and regulations. Adapt program strategies accordingly.
- Ensure that HEDIS programs are aligned with our organization's mission and values.
- Perform other duties as assigned.
Benefits
- robust benefits package to support our teams both professionally and personally
- competitive salary and retirement plans
- benefits beyond the typical medical, dental, and vision offerings
- fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Personify Health Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals
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What This Job Offers
Job Type
Full-time
Career Level
Manager
