Health Plan Quality Program Management & Performance Manager
J
JobgetherHealthcare quality
The position is remote, but candidates must reside in Michigan.Full-TimeManager
Salary66,456 - 129,590 USD per year
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Job Details
- Experience
- At least 6 years of healthcare experience, including a minimum of 4 years in health plan quality improvement, or an equivalent combination of relevant education and experience.
- Required Skills
- Project ManagementMicrosoft Excel
Requirements
- At least 6 years of healthcare experience, including a minimum of 4 years in health plan quality improvement, or an equivalent combination of relevant education and experience.
- Strong knowledge of HEDIS and NCQA quality standards and requirements.
- Experience managing quality improvement compliance deliverables related to state and federal regulators.
- Familiarity with Michigan Medicaid, managed care, or other government-sponsored healthcare programs.
- Strong business writing skills, including preparation of detailed reports, committee documentation, and regulatory deliverables.
- Proficiency in data analysis, manipulation, interpretation, and reporting.
- Demonstrated project management experience coordinating multiple high-priority deliverables and meeting strict deadlines.
- Proficiency in Microsoft Office applications, particularly Excel, and ability to learn new systems and software.
- Ability to work independently in a deadline-driven environment while managing competing priorities.
- Travel as required, including approximately 0–50% same-day travel and 0–20% overnight travel.
- Clinical licensure or certification may be required when mandated by applicable state contracts, regulations, business operating models, or licensing boards.
Responsibilities
- Lead quality program management activities to ensure compliance with state and federal regulations and NCQA requirements.
- Plan, implement, and maintain quality improvement activities that meet regulatory and reporting requirements.
- Oversee preparation for quality improvement reports, audits, accreditation surveys, and other required activities.
- Monitor quality deliverables for accuracy and timeliness, and present findings to leaders, stakeholders, and committees.
- Prepare narrative reports, interpret regulatory specifications, and document program outcomes and findings.
- Maintain quality program management plans and document applicable state, federal, and NCQA requirements.
- Lead quality improvement meetings and cross-functional discussions, and recommend corrective actions based on program results.
- Partner with quality leadership to investigate escalations, resolve issues, and remediate performance or compliance gaps.
- Provide training and ongoing support to quality management team members.
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