Quality Improvement Program Manager

4 weeks 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 (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.

Perks IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more. CalPERS retirement 457(b) option with a contribution match Generous paid time off- vacation, holidays, sick State of the art fitness center on-site Medical Insurance with Dental and Vision Paid life insurance for employees with additional options Short-term, and long-term disability options Pet care insurance Flexible Spending Account – Health Care/Childcare Wellness programs that promote a healthy work-life balance Career advancement opportunities and professional development Competitive salary with annual merit increase Team bonus opportunities

Education & Experience 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). Minimum possession of one of the following active, unrestricted, and unencumbered clinical licenses required:

Registered Nurse (RN) license issued by the California BRN Advanced clinical licensure issued by appropriate State Board (i.e. PA)

Key Qualifications Must have a valid California Driver’s license and valid automobile insurance.

Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points. 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. R equires 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. Start your journey towards a thriving future with IEHP and apply

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