Manager, Quality Performance and Outreach – CAHPS, HOS, Medicare

This is a fully remote position, open to applicants in Alabama, +25 more states.

📋 Description

• Lead strategic initiatives aimed at enhancing STARS, CAHPS, PWP, and HEDIS performance throughout the health plan and the organization.

• Concentrate on CAHPS and HOS metrics for Medicare, member incentives, and data analysis across all business lines.

• Direct cross-functional teams to design, implement, and assess outreach and quality improvement programs.

• Improve member experience, address care gaps, and ensure compliance with regulatory standards.

• Collaborate with various health plan departments, providers, vendors, and the broader enterprise.

• Supervise a team comprising 3 to 6 direct reports.

⛳️ Requirements

• Bachelor’s degree in Nursing, Clinical Sciences, Population Health, Healthcare Administration, Business Administration, or a related field is REQUIRED.

• A Registered Nurse License in Virginia or a Compact/Multi-state license is preferred.

• Minimum of 3 years of experience with HEDIS, STARS, PWP, or Clinical Improvement is REQUIRED.

• At least 3 years of supervisory or management experience is REQUIRED.

• Prior experience in Project Management and Performance Improvement is highly preferred.

• Strong project management and cross-functional collaboration abilities are REQUIRED.

• Capability to interpret clinical data and transform insights into actionable strategies is REQUIRED.

• Experience in working with vendors and managing outreach campaigns is REQUIRED.

• Health Plan experience is preferred.

🏝️ Benefits

• Medical, Dental, and Vision plans.

• Adoption, Fertility, and Surrogacy Reimbursement up to $10,000.

• Paid Time Off and Sick Leave.

• Paid Parental and Family Caregiver Leave.

• Emergency Backup Care.

• Long-Term, Short-Term Disability, and Critical Illness plans.

• Life Insurance.

• 401k/403B with Employer Match.

• Tuition Assistance of $5,250 per year, along with discounted educational opportunities through Guild Education.

• Student Debt Pay Down of $10,000.

• Reimbursement for certifications and complimentary access to complete CEUs and professional development.

• Pet Insurance.

• Legal Resources Plan.

• Colleagues have the opportunity to earn an annual discretionary bonus, contingent on fulfilling established system and employee eligibility criteria.