Clinical Quality Program Manager II
2 weeks ago
Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.)
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. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.
Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
As a condition of employment, L.A. Care requires a COVID-19 vaccine. This requirement includes our remote workforce. If you would like to request an exemption, L.A. Care has implemented a process to consider exemptions, for documented medical conditions and sincerely held religious beliefs. L.A. Care will review all exemption requests prior to proceeding with the recruitment process.
Job Summary
The Stars Program Manager (SPM) II is responsible for identifying, implementing, and guiding projects relating to quality excellence in Centers for Medicare and Medicaid Services (CMS) Five-Star Rating System and Marketplace Exchange Quality Rating Systems (QRS). The position is responsible for strategizing quality improvement programs and ongoing management using a data-driven focus that sets priorities for improvements aligned with ongoing strategic initiatives. This position collaborates with the Quality Improvement/ Quality Performance Management QI/QPM and Health Information Management (HIM) analytics support, Risk Adjustment, other plan operations business units, and network providers to strategize and promote success in achieving L.A. Care's enterprise wide quality goals and initiatives.
The SPM will develop and track the Stars work plan, implement short and long term operational goals to improve Stars ratings. The SPM will track, manage, and report project progress and outcomes. Manage vendor contracts. Facilitate collaboration with internal and external stakeholders to ensure that Stars initiatives are fully integrated throughout the organization.
Duties
Develop and maintain Stars work plan, convene committees and workgroups, and assist Stars Lead and Stars Core Team by leveraging technology and tools to streamline processes, enhance collaboration and synergy, promote data sharing, and improve transparency across clinical and operational areas.
Drive collaboration, education and training and maintaining working relationships across the Stars Core team and with multiple departments throughout LAC including but not limited to QI, Pharmacy, Care Management, Utilization Management, Risk Adjustment, Products, Customer Solution Center (CSC), reporting and Analytics, Appeals and Grievances and the provider network.
Manage and maintain the Stars SharePoint site to ensure all guidance from regulatory entities are available to key stakeholders and that enterprise-wide activities are documented and shared among accountable entities and network providers.
Coordinate workgroup meetings, send meeting reminders, format agendas, minutes and handouts. Manage the team SharePoint site. Follow up on meeting action items.
Work closely with QI, Health Services, Reporting/Analytics, vendors, and the provider network on shared quality initiatives, data sharing and analyses.
Monitor/track enterprise wide quality intervention and analytical strategies that elevate quality of care and enhance satisfaction for LAC members.
Work closely with Stars Core Team (Stars Lead and Manager Stars Analytics) to lead quality reporting and analytical strategies to enable accountable entities and stakeholders to drive quality ratings improvement for Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Outcome Survey (HOS), Healthcare Effectiveness Data and Information Set (HEDIS), Medication Adherence and Plan Operations.
Assist with identifying measures that need performance improvement, evaluate data, coordinate discussion/workgroup to develop strategy and work plan.
Research and implement best practices to improve population health, quality of life and evaluate impact.
Perform other duties as assigned.
Education Required
Bachelor's Degree
In lieu of degree, equivalent education and/or experience may be considered.
Education Preferred
Master's Degree
Experience
Required:
At least 5 years experience in a health plan specializing in healthcare quality, informatics, QI initiatives and analytics.
Experience in implementing initiatives to improve quality ratings and managing projects and programs end to end.
Preferred Experience
Consumer Assessment of Healthcare Providers and Systems (CAHPS)
Health Outcome Survey (HOS)
Skills
Required:
Thorough knowledge of health plan quality ratings and Stars.
Familiarity with HEDIS reporting and submission.
Demonstrated statistical analysis skills.
Must possess aptitude for accuracy and attention to details.
Proficient in Microsoft Office tools.
Ability to present data and analysis in a meaningful way, tailoring the message with audience in mind.
Excellent verbal, written and presentation skills.
Demonstrated critical thinking, problem-solving and process improvement skills.
Independent judgment and action skills to facilitate change as needed.
Knowledge of managed care industry standard performance assessment methods.
Able to work in a team environment, with good communication skills, supportive attitude and the ability to provide mentorship when appropriate.
Must demonstrate ability to work collaboratively and seek solutions proactively applying critical thinking skills in evaluating priorities and solutions.
Licenses/Certifications Required
Licenses/Certifications Preferred
Required Training
L.A. Care offers a wide range of benefits including
* Paid Time Off (PTO)
* Tuition Reimbursement
* Retirement Plans
* Medical, Dental and Vision
* Wellness Program
* Volunteer Time Off (VTO)
At L.A. Care, we value our team members' safety. In order to keep our work locations safe, each employee is required to self-screen for symptoms prior to entering any L.A. Care location each day. L.A. Care and all of its staff are required to comply with all state and local masking orders. Therefore, when on-site at any L.A. Care location, employees are expected to wear a mask in areas where physical distancing cannot be managed.
Nearest Major Market: Los Angeles
Job Segment: Medicaid, Pharmacy, Medical Research, Clinical Research, Medicare, Healthcare
-
Clinical Quality Program Manager II
4 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) 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. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five...
-
Clinical Quality Program Manager II
4 weeks ago
Los Angeles, United States L.A. Care Health Plan Full timeSalary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) 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. We are the nation’s largest publicly operated health plan. Serving more than 2 million...
-
Clinic Director II
1 week ago
Los Angeles, United States APLA Health Full timeJob DetailsJob LocationGleicher/Chen Health Center, Baldwin Hills - Los Angeles, CADescriptionPOSITION SUMMARY:Under the direction of the Senior Director, Clinical Operations, the Clinic Director II will provide mission-focused, strategic and process minded leadership and oversite of all nonclinical functions of the clinic and leadership of the clinical...
-
Quality Management Nurse Specialist RN II
1 month ago
Los Angeles, United States L.A. Care Health Plan Full timeSalary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) 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. We are the nation’s largest publicly operated health plan. Serving more than 2 million...
-
Quality Management Nurse Specialist RN II
3 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $88, Min.) - $115, Mid.) - $142, Max.) 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. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Quality Inspector Ii
1 month ago
Los Angeles, United States Total Aerospace Services Full timeDo you want to be a part of a team of aviation innovators who are helping change the industry landscape? Our client is the leading and most comprehensive provider of maintenance, repair, and overhaul (MRO) services and consultative repair solutions for military engines and accessories on mature platforms. Since 1978, they have been at the center of J85...
-
Clinical Research Associate II
1 month ago
Los Angeles, United States Cedars-Sinai Full timeJob DescriptionWe invite you to consider this great opportunity!When the work you do every single day has a crucial impact on the lives of others, every effort, every detail, and every second matters. This shared culture of happiness, passion, and dedication pulses through Cedars-Sinai.Dr. Omar Al-Louzi, MD is seeking a highly motivated Clinical Research...
-
Clinical Research Data Specialist Ii
1 month ago
Los Angeles, United States Springer Nature Full time**Clinical Research Data Specialist II - Center for Translational Geroscience (Hybrid)**: - Employer- Cedars-Sinai- Location- Los Angeles, California- Salary- Competitive- Closing date- 13 Jun 2024- Discipline Health Science Job Type Researcher Employment - Hours Full time Duration Permanent Qualification PhD Sector Hospital- You need to sign in...
-
Clinical Research Associate II
3 weeks ago
Los Angeles, California, United States Cedars-Sinai Full timeJob DescriptionWe invite you to consider this great opportunityWhen the work you do every single day has a crucial impact on the lives of others, every effort, every detail, and every second matters. This shared culture of happiness, passion, and dedication pulses through Cedars-Sinai.Dr. Omar Al-Louzi, MD is seeking a highly motivated Clinical Research...
-
Clinical Research Associate II
1 month ago
Los Angeles, California, United States Cedars-Sinai Full timeJob DescriptionWhen the work you do every single day has a crucial impact on the lives of others, every effort, every detail, and every second matters. This shared culture of happiness, passion, and dedication pulses through Cedars-Sinai.We invite you to consider this great opportunityThe Jona Goldrich Center for Alzheimer's and Memory Disorders brings...
-
Clinical Research Associate Ii
18 hours ago
Los Angeles, United States CEDARS-SINAI Full time**We invite you to consider this great opportunity!** When the work you do every single day has a crucial impact on the lives of others, every effort, every detail, and every second matters. This shared culture of happiness, passion, and dedication pulses through Cedars-Sinai. **Dr. Pascal Sati is seeking a highly motivated Clinical Research Associate II...
-
Clinical Research Data Specialist Ii
6 days ago
Los Angeles, United States CEDARS-SINAI Full time**Grow your career at Cedars-Sinai!** Cedars-Sinai offers a culture of happiness, passion, and dedication. This is one of the many reasons why we rank as one of the top hospitals in California and in the nation by U.S. News & World Report. The Clinical Research Data Specialist II manages the data for assigned research studies. This will include, designing...
-
Program Manager Clinical, Principal
2 weeks ago
Los Angeles, United States Hispanic Technology Executive Council Full timeYour Role The Care Management Department, which oversees all outpatient care management for the Commercial and Medicare lines of business, is seeking a Clinical Program Manager, Principal to join our team. In this role, the candidate will provide comprehensive support and collaborate effectively with stakeholders across various departments. The ideal...
-
Clinical Data Analyst II
3 weeks ago
Los Angeles, United States L.A. Care Health Plan Full timeSalary Range: $77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.) 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. We are the nation’s largest publicly operated health plan. Serving more than 2 million...
-
Enterprise Shared Services Program Manager Ii
4 weeks ago
Los Angeles, United States L.A. Care Health Plan Full timeEnterprise Shared Services Program Manager II (Limited Duration) **Job Category**:Administrative, HR, Business Professionals**Department**:Claims Data and Support Services**Location**:Los Angeles, CA, US, 90017**Position Type**:Full Time**Requisition ID**:11168**Salary Range**:$117,509.00** (Min.) - **$152,762.00** (Mid.) - **$188,015.00** (Max.)** -...
-
Clinical Research Associate II
3 weeks ago
Los Angeles, California, United States Cedars-Sinai Full timeJob DescriptionGrow your career at Cedars-SinaiThe Smidt Heart Institute reflects Cedars-Sinai's steadfast dedication to heart disease and research innovation giving patients access to the highest level of care. Year after year, thousands of people trust their hearts to Smidt Heart Institute at Cedars-Sinai. Our cardiologists, cardiac surgeons and niche care...
-
Clinical Data Analyst II
2 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $77, Min.) - $100, Mid.) - $123, Max.) 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. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Health Program Manager Ii
6 days ago
Los Angeles County, CA, United States Los Angeles County Department of Human Resources Full time**EXAM NUMBER**: - PH4542G**TYPE OF RECRUITMENT**: OPEN COMPETITIVE JOB OPPORTUNITY **FILING DATE**: Tuesday, May 14, 2024 at 8:30 a.m._,_ Pacific Time (PT)**DEFINITION**: Has immediate charge of a large-sized public health program or comparably-sized segment of a major public health program within the Department of Public Health. **CLASSIFICATION...
-
Care Management Initiatives Program Manager II
2 weeks ago
Los Angeles, United States L.A. Care Health Plan Full timeSalary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.) 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. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five...
-
Managing Attorney I/ii
6 days ago
Los Angeles, United States Catholic Charities of LA Full timeThe Managing Attorney I/II will work under the supervision of the Directing Attorney for Representation to provide supervision of legal representation to immigrants in removal proceedings and related state court proceedings, focusing particularly on cases involving detained adults, detained unaccompanied minors and minors released to sponsors in the LA...
