Quality Improvement Manager

This is a fully remote position, open to applicants in Idaho, +2 more states.

📋 Description

• Oversee the organization’s strategy for HEDIS performance, which includes monitoring, analysis, gap identification, and initiatives for improvement.

• Monitor and analyze HEDIS measures and other quality metrics to pinpoint trends, obstacles, and opportunities for enhancement.

• Design and implement interventions aimed at closing care gaps and enhancing clinical outcomes.

• Supervise quality goals at the organizational, payer, and provider levels.

• Ensure alignment of quality initiatives with regulatory standards, payer expectations, and organizational objectives.

• Convert quality data into actionable insights for clinical and operational teams.

• Lead, manage, and mentor a team focused on HEDIS, quality improvement, care gap closure, and payer incentive initiatives.

• Set team objectives, workflows, priorities, and performance standards.

• Assess team productivity and enhance processes.

• Act as the organization’s expert on quality-related functionalities within the EMR.

• Acquire in-depth knowledge of quality measures, care gaps, clinical documentation, workflows, health maintenance, registries, and reporting within the EMR.

• Enhance EMR workflows and functionalities to bolster quality performance.

• Create and deliver training on HEDIS measures, quality requirements, payer programs, documentation, and care gap closure.

• Develop educational materials, tools, and resources aimed at quality improvement.

• Foster organizational awareness and accountability regarding quality performance.

• Collaborate with the Director of Population Health, clinical providers, operational leaders, IT/EMR teams, analytics teams, and executive leadership.

⛳️ Requirements

• A Bachelor’s degree in healthcare administration, nursing, public health, health information management, or a related field is preferred.

• 3–5+ years of experience in healthcare quality, HEDIS, population health, payer quality programs, or quality improvement.

• Experience in managing or supervising a team.

• Comprehensive knowledge of HEDIS measures, quality metrics, care gaps, and payer incentive programs.

• Familiarity with EMR systems and their quality-related functionalities, reporting, registries, and workflows.

• Experience with Cerner/Oracle Health is highly preferred.

• Strong analytical abilities to interpret quality data and convert findings into actionable strategies for improvement.

• Excellent communication, presentation, and organizational abilities.

• Capability to collaborate effectively with clinical providers, operational leaders, IT/EMR teams, analytics teams, and executive leadership.

• Ability to meet physical requirements, including standing, walking, reaching, talking, hearing, occasional sitting/stooping/kneeling/crouching, and lifting up to 50 pounds.

🏝️ Benefits

• Opportunity for a Hepatitis-B vaccination series for employees engaged in tasks that involve exposure to blood, body fluids, and/or tissues.