Quality Improvement Program Manager - St. Luke's Health Plan

St. Luke's Health System•Boise, ID

2d•Hybrid

About The Position

At St. Luke’s, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke’s is truly a great place to work. We are seeking a Quality Improvement Program Manager to join our team. As our Quality Improvement Program Manager, you will lead and coordinate the Health Plan's Quality Improvement Program and accreditation activities. This role is responsible for managing the annual QI Work Plan, tracking opportunities for improvement, supporting NCQA accreditation, quality reporting requirements, and facilitating initiatives that improve member outcomes, member experience, and overall plan performance. Working closely with accreditation, quality reporting, Stars, provider network, customer service, utilization management, analytics, and vendor partners, you will help translate insights into measurable results and support continuous improvement across the organization.

Requirements

Bachelor's degree or experience in lieu of.
Four (4) years' relevant experience.

Nice To Haves

Knowledge of NCQA Health Plan Accreditation standards, Quality Improvement requirements, and quality program governance.
Experience in health plan quality improvement, population health, healthcare quality management, or healthcare performance improvement.
Experience supporting quality measure reporting, regulatory audits, accreditation activities, and performance improvement initiatives.
Experience using healthcare data, quality metrics, and performance reporting to identify opportunities and measure improvement outcomes.
Project management experience coordinating multiple workstreams, stakeholders, and regulatory deadlines.

Responsibilities

Lead coordination of the Health Plan Quality Improvement (QI) Program, including management of the annual QI Work Plan, NCQA accreditation requirements, committee activities, annual program evaluation, and oversight of improvement activities and supporting documentation throughout the year.
Identify, prioritize, and facilitate opportunities for improvement, including development, implementation, and evaluation of interventions and PDSA (Plan-Do-Study-Act) cycles.
Support annual quality reporting activities, including project plan management, milestone tracking, measure reporting readiness, and quality review of medical record abstraction and overread activities.
Maintain regulatory and audit readiness documentation and support internal and external reviews related to quality programs, accreditation, and reporting requirements.
Assist with oversight of chronic care improvement initiatives, including monitoring performance, evaluating outcomes, implementing interventions, and supporting regulatory requirements.
Prepare reports, presentations, committee materials, and performance summaries that communicate program results, improvement opportunities, intervention outcomes, and accreditation-related activities.
Partner with quality, operational, analytics, and vendor teams to support quality improvement initiatives and advance organizational goals.