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Form of workJob Description
**HYBRID remote with some in office or field work**
The Senior Manager of Quality Improvement (“Manager”) will have oversight responsibilities in the development and management of the quality improvement department for all product-lines within the organization. Additionally, the Manager will be responsible for collaborating with management, the quality improvement (“QI”) staff, other internal staff, and other entities (ancillary providers, provider offices, health plans, and other stakeholders) to develop strategic goals and initiatives to drive success in all quality improvement areas. The Manager will be responsible for updating the QI work plan and ensure elements in the work plan are followed through to meet sensitive timelines. The Manager will develop tools and mechanisms to measure and trend performance on a weekly, monthly, quarterly, semi-annually and/or annual basis.
The Manager will be working in conjunction with the provider relations department, quality improvement staff, and other internal and external contacts to engage providers and members to achieve quality measures. The Manager will complete quality improvement projects in a timely manner and meet set outcome goals based upon health plan performance benchmarks and goals as stipulated in the QI work plan. The Manager will interface with internal and external entities or other stakeholders including health plans, providers, ancillary providers to ensure key quality improvement initiatives of the department are aligned with the core organization goals.
The key Quality Improvement Manager primary assignments include quality projects for all product lines (Medicare, Medi-Cal, and Covered CA) including HCC, HEDIS, Medicare STARs (Part C & D), CAHPs, encounter data, and internal provider quality incentive program.
