Quality Improvement Program Manager - St. Luke's Health Plan

The QI (Quality Improvement) Program Manager is responsible for optimizing the Health Plan's quality improvement program, including HEDIS and member experience surveys, such as CAHPS. Works closely with cross-functional teams to optimize HEDIS measures and manage quality improvement projects.

What You Can Expect:

• Build and document processes and workflows for a newly established Quality department, including standard procedures for HEDIS, CAHPS, and QI activities.
  • Coordinate assigned work across teams and vendors by tracking tasks, confirming data accuracy, and escalating issues when needed.
  • Manage multiple QI projects at the same time, organizing work, meeting deadlines, and supporting day-to-day execution in a fast-moving environment.
  • Support HEDIS and accreditation tasks by executing processes to meet QI accreditation standards, maintaining documentation, preparing required materials, ensuring accurate and timely reporting, and facilitate audit processes.

Duties/Responsibilities:

• Collaborate with Information Health Technology (IHT) and vendor teams to ensure accurate and timely data collection and reporting.
• Monitor, analyze, and prioritize HEDIS and CAHPS data.
• Utilize data analytics and performance metrics to identify areas for improvement using annual and prospective data.
• Propose new quality improvement programs. Develop and support implementation of approved programs, setting clear goals and objectives. Organize cross-functional efforts to optimize current programs and execute new programs targeted at Health Plan quality improvement.
• Maintain comprehensive documentation and accurate records of quality improvement initiatives, programs, activities, and outcomes.
• Present results of quality improvement programs on targeted HEDIS measures to management and impacted teams.
• Ensure compliance with healthcare regulations and accreditation standards, such as NCQA, HEDIS, and CMS.
• Stay updated on changes in HEDIS and PQA measures and regulations. Adapt program strategies accordingly.
• Ensure that HEDIS programs are aligned with our organization's mission and values.
• Perform other duties as assigned.

Minimum Qualifications:

• Education: Bachelor's degree or experience in lieu of
• Experience: 4 years of relevant experience
• Licenses/Certifications: None

At St. Luke’s, caring for people in the communities we serve is our mission – and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Personify Health Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals.

St. Luke’s is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law.

*Please note: this posting is not reflective of all job duties and responsibilities and is intended to provide an overview to job seekers.