Quality Improvement Manager

The Project Manager of Quality Improvement (“Manager”) will partner with physician offices, Health Plan, Quality Improvement Managers/staff and other departments within Preferred IPA to meet performance expectations established by the State and CMS entities for HEDIS/Stars, Risk Adjustment and other quality improvement areas.

The Manager will develop/revise the QI work plan and ensure elements in the work plan are followed through to meet sensitive timelines. Assist QI manager to develop tools/mechanisms to measure and trend performance on a weekly, monthly, quarterly, semi-annually and/or annual basis.

The Manager will be working in conjunctions with the provider representative, QI staff and other staff internally and externally to engage providers/members to complete quality improvement projects in a timely manner and meet set outcome goals stipulated in the QI work plan and/or health performance benchmark/goals. The Manager will interface with various internal and external entities or other health care stakeholders (health plans, providers, ancillary vendors, etc.) to ensure key quality improvement initiatives are aligned with the core organization goals.

Experience:

· Bilingual (English and Spanish) preferred.

· Strong interpersonal and organization skills

· 3-5 years of managerial experience and managing projects in Heath Care

· Experience with health care quality in HEDIS/Stars, HCC and encounter data

· Bachelor’s degree

· Familiarity and experience with Cueva and EMR (Office Ally, NexGen, eClinicalWorks, etc.)

· Experience using Adobe Acrobat, Word, Excel, Access, Visio and PowerPoint. Strong knowledge in creating graphs and data analysis in Excel.

Job Responsibilities:

Assist Quality Improvement Managers:

· with supervision of Quality Improvement staff as needed by preparing necessary reports on performance status.

· Available to take on special projects as needed.

· Assist with obtaining EMR access for Coders.

· Assist managers, so manager can emphasize more on trainings with physicians and specialist prepare a coding tool .

· To assist monitoring HEDIS performance with Senior members

· Attend and follow-up with health plan JOM action items, coordinate projects with QI and PR teams to ensure joint projects are completed timely.

· Monitor and report physician office challenges and changes needed to implement Cozeva.

· Interface and partner with various Health Plan staff for Quality Compliance initiatives and develop work plan and timeline(s) to complete requirements.

· Conduct training and communicate Quality Compliance requirements to provider offices in person or group presentations via WebEx.

· Preparing internal performance reports for managers.

· Provider Intervention/Engagement with provider offices and track office progress and share reports with staff in meetings on Quality Compliance.

· Assist quality managers to develop tools to measure quality improvement performance and to establish goals for provider offices and QI team members.

· Local travel up to 50% dependent upon business and client needs.

· Have valid driver license and proof of insurance.

· Other projects or responsibilities as assigned.

Pay: $70,000.00 - $75,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Education:

• Bachelor's (Preferred)

Experience:

• Quality Improvement : 5 years (Required)

Work Location: Hybrid remote in Glendale, CA 91202

Salary : $70,000 - $75,000