Manager, Quality Performance and Outreach – STARS, CAHPS, PWP, HEDIS
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Job Description
Manager of Quality Performance and Outreach driving initiatives for STARS, CAHPS, PWP, and HEDIS. Collaborating with various departments to enhance quality improvement programs.
Responsibilities:
- Play a critical role in driving strategic initiatives to improve STARS, CAHPS, PWP, and HEDIS performance across the health plan and enterprise.
- Lead cross-functional efforts to design, implement, and evaluate outreach and quality improvement programs that enhance member experience, close care gaps, and support regulatory compliance.
- Focus on all lines of business, including Commercial, Medicaid, and Medicare, collaborating with other health plan departments, providers, vendors, and the enterprise.
- Manage a Team of 4 Direct Reports.
Requirements:
- Bachelor’s degree in Nursing, Clinical Sciences, Population Health, Healthcare Administration, Business Administration, or related field REQUIRED
- Registered Nurse License in Virginia OR Compact/Multi-state preferred
- 3 years of experience with HEDIS, STARS, PWP, or Clinical Improvement REQUIRED
- 3 years of supervisory or management experience REQUIRED
- Prior experience in Project Management and Performance Improvement preferred
- Strong project management and cross-functional collaboration skills REQUIRED
- Ability to interpret clinical data and translate insights into actionable strategies REQUIRED
- Experience working with vendors and managing outreach campaigns REQUIRED
- Health Plan experience is preferred.
Benefits:
- Medical, Dental, Vision plans
- Adoption, Fertility and Surrogacy Reimbursement up to $10,000
- Paid Time Off and Sick Leave
- Paid Parental & Family Caregiver Leave
- Emergency Backup Care
- Long-Term, Short-Term Disability, and Critical Illness plans
- Life Insurance
- 401k/403B with Employer Match
- Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
- Student Debt Pay Down – $10,000
- Reimbursement for certifications and free access to complete CEUs and professional development
- Pet Insurance
- Legal Resources Plan
- Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
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