Quality Improvement Program Manager

2 weeks ago

Rancho Cucamonga CA, United States Inland Empire Health Plan Full time

Under the direction of department leadership, the Quality Improvement Program Manager will drive quality improvement initiatives across the continuum of care (i.e. acute care hospitals, skilled nursing facilities, hospice agencies, etc.) to enhance the overall quality of care delivered to Members. Responsible for identifying, developing, coordinating, promoting, supporting, and implementing assigned clinical quality, and/or service improvement projects and programs, the Quality Improvement Program Manager acts as a lead for evidence-based practice integration, provider training/education, policy review/development, and regulatory/accreditation interpretation. Specifically, develops continuous and targeted activities to improve performance related to Centers for Medicare & Medicaid Services (CMS) Star Ratings, HEDIS, CAHPS, HOS, P4P and other identified performance measures. Manages multiple complex initiatives that impact the quality or effectiveness of health care delivery and/or health care services. Acts in conjunction with both external facing and plan quality improvement leaders and key stakeholders to provide support for multi-disciplinary teams.
including IEHP and external stakeholder workgroups which support key quality improvement initiatives. network-wide CMS star ratings and individual domain-level performance.
Develop collaborative relationships with contracted hospitals, skilled nursing facilities, hospice agencies, providers, and other external partners to promote participation in quality improvement collaboratives (i.e. forums to enhance shared learning opportunities and/or share best practices) to improve clinical care outcomes.
Utilize knowledge of advanced clinical processes and/or hospital operations to collaboratively develop and implement targeted activities (i.e., those based on current outcome performance and/or aligned with industry best-practices) to drive improvements in CMS Star Ratings, HEDIS, CAHPS, HOS, P4P and other identified performance measures
Perform continuous monitoring of improvement activities via concurrent analysis of measure outcomes.
Analyze performance outcomes and provide meaningful feedback (i.e., to external partners in relation to process improvement enhancements.
Effectively utilize performance improvement methodologies (i.e., Plan Do Study Act (PDSA)) lead the development, refinement, and implementation of rapid-cycle performance improvement.
Participate and describe outreach initiatives, potential/experienced barriers, and activities to resolve issues and improve outcomes.
Participate in the development and maintenance of annual quality improvement program documents and evaluations, compliance audits, policies and procedures, and improvement activities.
Support the development, upgrade, and delivery of comprehensive quality improvement training programs and problem-solving methodologies/tools to QI teams and other stakeholders as needed in collaboration with the quality improvement team.
Lead intradepartmental quality improvement teams, programs, projects, and initiatives as assigned.
Continuously seek to enhance delivery and efficiency of external-facing quality improvement initiatives via technological advancement and internal-facing process improvement.
Translate data into meaningful information, draw conclusions, and relate findings to industry standards. Provide recommendations to departmental stakeholders and Quality Improvement Leadership Team regarding performance gaps, program implementation, and performance outcomes in order to maintain an effective Quality Improvement program.
Any other duties as required ensuring Health Plan operations are successful.
Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.
CalPERS retirement
Generous paid time off- vacation, holidays, sick
Medical Insurance with Dental and Vision
Short-term, and long-term disability options
Flexible Spending Account – Health Care/Childcare
Minimum six (6) years of experience in a clinical/health care environment with demonstrated experience at a professional level in quality improvement/clinical program oversight/project management.
Bachelor’s degree in science or health/healthcare related field from an accredited institution required.
Certified Professional of Healthcare Quality (CPHQ), or other recognized quality improvement certificate required or within one (1) year of hire (maintained through employment).
Working knowledge of healthcare quality performance and measurement sets including CMS quality withhold, Managed Care Accountability Set, NCQA Quality Improvement Standards and HEDIS.
Ability to apply knowledge of project management techniques, tools of continuous improvement, and work process redesign.
Knowledge of advanced clinical processes and/or hospital operations.
Requires knowledge of the local healthcare market, patient demographics and needs and plan-specific information.
Proficient in all Microsoft Office applications, with an emphasis on Excel, PowerPoint and Visio.

  • Quality Improvement Program Manager

    3 weeks ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    What you can expect!Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!Under the direction of department leadership, the Quality Improvement Program Manager will drive quality improvement initiatives across the continuum of care...

  • Quality Improvement Program Manager

    2 weeks ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    Overview: What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience! Under the direction of department leadership, the Quality Improvement Program Manager will drive quality improvement initiatives across the continuum of care...

  • Quality Improvement Program Manager

    3 days ago

    Rancho Cucamonga, United States Inland Empire Health Plans Full time

    What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of department leadership, the Quality Improvement Program Manager will drive quality improvement initiatives across the continuum of care...

  • Quality Improvement Program Manager, RN

    5 days ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of department leadership, the Quality Improvement Program Manager will drive quality improvement initiatives across the continuum of care...

  • Quality Improvement Facilitator II

    3 weeks ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    What you can expect!Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!Under the direction of management, and with minimal supervision, the Quality Improvement (QI) Facilitator II works closely with front line leaders, external...

  • Quality Improvement Nurse, RN

    4 weeks ago

    Rancho Cucamonga, United States IEHP Full time

    Start your journey towards a thriving future with IEHP and apply TODAY!Pay RangeUSD $43.87 - USD $58.13 /Hr.What you can expect! Under the direction of the Supervisor, Clinical Quality Improvement, the HEDIS Improvement Nurse provides support to the Supervisor, Clinical Quality Improvement and IEHP departments on HEDIS improvement related issues, serving as...

  • Quality Improvement Nurse, RN

    4 weeks ago

    Rancho Cucamonga, United States IEHP Full time

    Start your journey towards a thriving future with IEHP and apply TODAY!Pay RangeUSD $43.87 - USD $58.13 /Hr.What you can expect! Under the direction of the Supervisor, Clinical Quality Improvement, the HEDIS Improvement Nurse provides support to the Supervisor, Clinical Quality Improvement and IEHP departments on HEDIS improvement related issues, serving as...

  • Quality Improvement Nurse, RN

    4 weeks ago

    Rancho Cucamonga, United States IEHP Full time

    Start your journey towards a thriving future with IEHP and apply TODAY!Pay RangeUSD $43.87 - USD $58.13 /Hr.What you can expect! Under the direction of the Supervisor, Clinical Quality Improvement, the HEDIS Improvement Nurse provides support to the Supervisor, Clinical Quality Improvement and IEHP departments on HEDIS improvement related issues, serving as...

  • Direct Service Advisor

    7 days ago

    Rancho Cucamonga, United States Vocational Improvement Program Inc Full time

    Be the Direct Service Advisor (DSA) that is going to change the lives of others! We are looking for a creative and energetic DSA that will introduce individuals with disabilities, also referred to as clients, to new job opportunities while simultaneously improving their job readiness! VIP has assisted thousands of adults with intellectual disabilities...

  • Quality Improvement Nurse, RN

    1 week ago

    Rancho Cucamonga, CA, United States IEHP Full time

    Start your journey towards a thriving future with IEHP and apply TODAY!Pay RangeUSD $43.87 - USD $58.13 /Hr.What you can expect! Under the direction of the Supervisor, Clinical Quality Improvement, the HEDIS Improvement Nurse provides support to the Supervisor, Clinical Quality Improvement and IEHP departments on HEDIS improvement related issues, serving as...

  • RN-Manager Quality/Process Improvement

    3 days ago

    Rancho Mirage, United States Eisenhower Health Full time

    Job Objective: A brief overview of the position.The RN- Manager Clinical Quality/Process Improvement effectively executes the safety and quality agenda and system standards of practice to ensure safety, quality, and experience of care at every point of service as well as employee and patient safety across the professional nursing practice, clinical areas and...

  • Site Program Manager

    1 month ago

    Rancho Cucamonga, United States Think Together Full time

    Overview: **Job Title: Site Program Manager** **Status: Full Time, Exempt** **ESSENTIAL DUTIES AND RESPONSIBILITIES**: - Manages successful day-to-day site operations and program activities. - Ensures that all program activities operate consistently and ethically within the mission and values of Think Together and align with the four core agreements: 1) Be...

  • Quality Engineer

    1 month ago

    Rancho Cucamonga, United States Tekni-Plex Full time

    Quality Engineer "Come build a Career with our Growing, Fast-Paced, Customer-Focused Company that fosters Training & Professional Development!" Do you have a passion for Quality and are looking for a new challenge and an exciting opportunity to advance your knowledge, skills and career in a great working environment? Would you like to have a job that allows...

  • Quality Engineer

    2 weeks ago

    Rancho Cucamonga, United States Amtec, LLC Full time

    The Quality Engineer is responsible for ensuring product quality through all levels of the supply chain of a vertically integrated manufacturer. The Quality Engineer plans and conducts activities with both internal and external stakeholders to control production processes through implementation of inspection plans, failure analysis investigations, and...

  • HEDIS Improvement Nurse, RN

    3 weeks ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    What you can expect!Under the direction of the Supervisor, Clinical Quality Improvement, the HEDIS Improvement Nurse provides support to the Supervisor, Clinical Quality Improvement and IEHP departments on HEDIS improvement related issues, serving as a resource for internal and external customers. Is able to interpret clinical data for QI-related studies for...

  • Legal Program Manager

    1 day ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    Overview: What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience! This is a unique opportunity to play a crucial role in support of the Legal Departments Board Services team that primarily serves the Inland Empire Health...

  • RN/Registered Nurse

    8 hours ago

    Rancho Mirage, United States Eisenhower Health Full time

    Job Objective: A brief overview of the position.The RN- Manager Clinical Quality/Process Improvement effectively executes the safety and quality agenda and system standards of practice to ensure safety, quality, and experience of care at every point of service as well as employee and patient safety across the professional nursing practice, clinical areas and...

  • Home Improvement Consultant

    6 days ago

    Rancho Cucamonga, United States HavenHub Full time

    **Start your exciting new career in Homes Solutions and Services** We're on the lookout for talented individuals in Orange County & Inland Empire, California. **About Us** HavenHub is revolutionizing home services. By combining cutting-edge technology with exceptional customer service, we deliver seamless solutions for homeowners nationwide. Join our...

  • Quality Review Nurse, RN

    2 weeks ago

    Rancho Cucamonga, United States Alura Workforce Solutions Full time

    Position Quality Review Nurse, RN Description MUST live in California and be able to wrok a hybrid position. Reporting to the Manager of Provider Quality Oversight, the Provider Quality Review Nurse, RN is responsible for: - Receive and research all PQI and QR cases as assigned, provide a summary and recommendations to the Medical Director of case...

  • RN-Infection Control

    21 hours ago

    Rancho Mirage, United States Eisenhower Medical Center Full time

    * Share Job: * Email * Facebook * Linkedin chevron_left Back To Results Located in the heart of the Coachella Valley, you have access to resort-style living and world-class amenities throughout Southern California. * Job Objective: A brief overview of the position. * Responsible for assisting in coordinating an effective hospital-wide program for the...