Quality Improvement Manager

3 days ago


Orange, California, United States Astiva Health, Inc Full time
Job Title: Manager of Quality Improvement

At Astiva Health, Inc., we are seeking a highly skilled and experienced Manager of Quality Improvement to join our team. This key leadership role is responsible for overseeing key medical management functions, including Quality Management, Quality Improvement (QI), Risk Adjustment Factors, and Quality Assurance.

Key Responsibilities:
  • Develop and implement strategies to improve HEDIS, CAHPS, HOS, and other STARS-related measures.
  • Collaborate with internal departments to ensure compliance with the QI program and its policies and procedures.
  • Present reports and facilitate review and action by the Utilization Management/Quality Assurance Committee and Board of Directors Meetings.
  • Recruit and retain competent staff and develop leaders to execute strategy and operations.
  • Ensure compliance with all applicable federal, state, and local regulations.
Requirements:
  • 7+ years of Managed-Care operations experience at a manager level required.
  • 5+ years of QI experience, preferably at the plan level, required.
  • Masters degree in Public Health, Health Science, or RN/NP/BSN licensure.
  • HMO, Medi-Cal/Medicaid, Medicare, and insurance experience or relevant government client or public service experience preferred.
Benefits:
  • 401(k)
  • Dental Insurance
  • Health Insurance
  • Life Insurance
  • Vision Insurance
  • Paid Time Off


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