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Quality Improvement Manager
2 months ago
We are seeking a highly skilled Quality Improvement Manager to join our team at Santa Clara Family Health Plan. This is a critical role that will oversee the day-to-day operations of quality improvement and health equity activities, ensuring that our members receive high-quality care.
Key Responsibilities- Collaborate with internal stakeholders and external partners to drive quality improvement projects, improving quality of care and quality of service.
- Develop and monitor key performance indicators, metrics, and programs related to quality improvement activities, including data analysis and reporting.
- Manage the Quality Improvement and Health Equity programs, including Performance Improvement Projects (PIPs), Quality Improvement Projects (QIPs), HEDIS, quality analytics, and regulatory submissions.
- Lead and manage staff responsible for quality improvement activities, providing guidance and support to ensure successful project outcomes.
- Identify issues, trends, and opportunities for improvement, developing recommendations and implementing solutions to address these areas.
- Maintain a thorough knowledge of applicable laws and regulations, ensuring compliance with CMS, DHCS, DMHC, and other relevant agencies.
- Develop policies and procedures to ensure adherence to contractual, legal, and regulatory requirements.
- Attend off-site meetings and events as necessary.
- Bachelor's Degree in Health Administration, Public Health, Nursing, or related field; or equivalent experience, training, or coursework.
- Minimum two years of experience with quality improvement and health equity activities, including experience running a full cycle of HEDIS.
- Strong understanding of quality improvement methodologies and data analysis skills.
- Ability to think creatively and work strategically, driving innovative solutions to improve quality outcomes.
- Excellent communication and interpersonal skills, with the ability to effectively facilitate meetings and deliver presentations to management, regulators, and staff.
- Self-directed with the ability to assume responsibility, work independently, and manage competing initiatives in a fast-paced environment.
This is a full-time position, primarily performed in an office environment. Incumbents are subject to regular contact with co-workers, managers, external partners, and vendors in person, by telephone, and via work-related electronic communications.
Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation.
