Quality Improvement Program Manager

Jefferson Health Plans•Philadelphia, PA

3d•Onsite

About The Position

The Quality Improvement (QI) Program Manager is responsible for coordinating and supporting quality improvement initiatives across all lines of business within the health plan. This role oversees operational activities related to care gap closure, member outreach events, in-home appointment scheduling, regulatory quality reporting support, and maintenance of quality performance dashboards and work plans. The Program Manager partners closely with clinical, operational, vendor, provider, and regulatory teams to improve quality outcomes, member experience, and regulatory compliance.

Requirements

Bachelor’s Degree
2 years working experience in project management required
Strong problem-solving, quantitative and analytical skills required
Proficient use of Microsoft Office suite (Word, Power Point, Excel) required
Strong project management and organizational skills with the ability to manage multiple priorities simultaneously
Excellent organizational, interpersonal and time management skills required
Ability to organize and manage multiple priorities
Ability to work independently and as part of a team
Detail-oriented with strong follow-through and accountability
Excellent written and verbal communication skills
Flexibility is required to deal with diverse situations and a changing environment
Ability to quickly learn and implement knowledge of new business processes required

Responsibilities

Coordinate and support quality improvement activities designed to improve performance on regulatory and accreditation measures, including HEDIS, Medicare Advantage Stars, Medicaid quality programs, and state-specific initiatives.
Provide operational oversight for vendor-led in-home appointment campaigns and community events, including member data file creation, secure data transfer, and performance tracking.
Track outreach activities, appointment completion rates, and event outcomes to ensure performance targets are met.
Support the Regulatory and Quality Reporting teams with preparation, validation, and submission of required reports to the Department of Human Services (DHS), CMS, NCQA, and other regulatory agencies.
Design, maintain, and update quality dashboards, scorecards, and performance tracking reports in collaboration with Analytics and Reporting teams.
Monitor progress toward organizational quality goals and escalate risks or gaps to leadership.
Partner with clinical leadership, analytics, provider relations, operations, population health, and regulatory teams to support enterprise quality goals.

Benefits

medical (including prescription)
supplemental insurance
dental
vision
life and AD&D insurance
short- and long-term disability
flexible spending accounts
retirement plans
tuition assistance
voluntary benefits
tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service