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Clinical Quality Program Manager II
4 months ago
- Minimum: $88,854.00
- Midpoint: $115,509.00
- Maximum: $142,166.00
Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. Serving more than 2 million members in five health plans, L.A. Care ensures members receive quality care when needed.
Mission: L.A. Care's goal is to grant access to quality healthcare for vulnerable and low-income communities in Los Angeles County, reinforcing the safety net required to fulfill this purpose.
As part of employment, L.A. Care mandates a COVID-19 vaccine. Exemptions may be requested for medical conditions or religious beliefs.
The Stars Program Manager (SPM) II oversees projects related to quality excellence in Centers for Medicare and Medicaid Services (CMS) Five-Star Rating System and Marketplace Exchange Quality Rating Systems (QRS). Collaborating with various units, this role focuses on quality improvement programs with a data-driven approach to meet strategic goals.
Responsibilities include developing and monitoring Stars work plans, managing project progress, fostering collaboration, and ensuring integration of Stars initiatives across the organization.
Duties- Develop and maintain Stars work plan
- Facilitate collaboration across various departments
- Maintain Stars SharePoint site
- Coordinate meetings and follow up on action items
- Monitor enterprise-wide quality intervention strategies
- Lead quality reporting and analytical strategies
- Identify areas for performance improvement
- Research best practices for population health
- Perform assigned duties
Bachelor's Degree or equivalent education/experience.
Education PreferredMaster's Degree
ExperienceRequired: Minimum 5 years experience in healthcare quality within a health plan.
Experience in enhancing quality ratings and managing projects.
Preferred ExperienceConsumer Assessment of Healthcare Providers and Systems (CAHPS)
Health Outcome Survey (HOS)
SkillsRequired:
- Knowledge of health plan quality ratings and Stars
- Familiarity with HEDIS reporting
- Statistical analysis skills
- Attention to detail
- Proficiency in Microsoft Office
- Presentation and communication skills
- Critical thinking and problem-solving abilities
- Adaptability and teamwork skills
- Managed care industry knowledge
L.A. Care offers various benefits:
- Paid Time Off (PTO)
- Tuition Reimbursement
- Retirement Plans
- Medical, Dental, and Vision coverage
- Wellness Program
- Volunteer Time Off (VTO)
L.A. Care prioritizes the safety of its staff, requiring daily self-screening for symptoms and compliance with masking orders.
