Inland Empire Health Plans
Quality Improvement Program Manager
Inland Empire Health Plans, Rancho Cucamonga, California, United States, 91739
What you can expect!Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an
authentic experience!Under the direction of department leadership, the Quality Improvement Program Manager will drive quality improvement initiatives across the continuum of care (i.e. acute care hospitals, skilled nursing facilities, hospice agencies, etc.) to enhance the overall quality of care delivered to Members. Responsible for identifying, developing, coordinating, promoting, supporting, and implementing assigned clinical quality, and/or service improvement projects and programs, the Quality Improvement Program Manager acts as a lead for evidence-based practice integration, provider training/education, policy review/development, and regulatory/accreditation interpretation. Specifically, develops continuous and targeted activities to improve performance related to Centers for Medicare & Medicaid Services (CMS) Star Ratings, HEDIS, CAHPS, HOS, P4P and other identified performance measures. Manages multiple complex initiatives that impact the quality or effectiveness of health care delivery and/or health care services. Acts in conjunction with both external facing and plan quality improvement leaders and key stakeholders to provide support for multi-disciplinary teams.
PerksIEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.CalPERS retirement457(b) option with a contribution matchGenerous paid time off- vacation, holidays, sickState of the art fitness center on-siteMedical Insurance with Dental and VisionPaid life insurance for employees with additional optionsShort-term, and long-term disability optionsPet care insuranceFlexible Spending Account – Health Care/ChildcareWellness programs that promote a healthy work-life balanceCareer advancement opportunities and professional developmentCompetitive salary with annual merit increaseTeam bonus opportunities
Education & ExperienceMinimum six (6) years of experience in a clinical/health care environment with demonstrated experience at a professional level in quality improvement/clinical program oversight/project management.Bachelor’s degree in science or health/healthcare related field from an accredited institution required.Certified Professional of Healthcare Quality (CPHQ), or other recognized quality improvement certificate required or within one (1) year of hire (maintained through employment).Minimum possession of one of the following active, unrestricted, and unencumbered clinical licenses required:
Registered Nurse (RN) license issued by the California BRNAdvanced clinical licensure issued by appropriate State Board (i.e. PA)
Key QualificationsMust have a valid California Driver’s license and valid automobile insurance. Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points.Working knowledge of healthcare quality performance and measurement sets including CMS quality withhold, Managed Care Accountability Set, NCQA Quality Improvement Standards and HEDIS.Ability to apply knowledge of project management techniques, tools of continuous improvement, and work process redesign.Knowledge of advanced clinical processes and/or hospital operations.Requires knowledge of the local healthcare market, patient demographics and needs and plan-specific information.Proficient in all Microsoft Office applications, with an emphasis on Excel, PowerPoint and Visio.Start your journey towards a thriving future with IEHP and apply
TODAY !
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authentic experience!Under the direction of department leadership, the Quality Improvement Program Manager will drive quality improvement initiatives across the continuum of care (i.e. acute care hospitals, skilled nursing facilities, hospice agencies, etc.) to enhance the overall quality of care delivered to Members. Responsible for identifying, developing, coordinating, promoting, supporting, and implementing assigned clinical quality, and/or service improvement projects and programs, the Quality Improvement Program Manager acts as a lead for evidence-based practice integration, provider training/education, policy review/development, and regulatory/accreditation interpretation. Specifically, develops continuous and targeted activities to improve performance related to Centers for Medicare & Medicaid Services (CMS) Star Ratings, HEDIS, CAHPS, HOS, P4P and other identified performance measures. Manages multiple complex initiatives that impact the quality or effectiveness of health care delivery and/or health care services. Acts in conjunction with both external facing and plan quality improvement leaders and key stakeholders to provide support for multi-disciplinary teams.
PerksIEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.CalPERS retirement457(b) option with a contribution matchGenerous paid time off- vacation, holidays, sickState of the art fitness center on-siteMedical Insurance with Dental and VisionPaid life insurance for employees with additional optionsShort-term, and long-term disability optionsPet care insuranceFlexible Spending Account – Health Care/ChildcareWellness programs that promote a healthy work-life balanceCareer advancement opportunities and professional developmentCompetitive salary with annual merit increaseTeam bonus opportunities
Education & ExperienceMinimum six (6) years of experience in a clinical/health care environment with demonstrated experience at a professional level in quality improvement/clinical program oversight/project management.Bachelor’s degree in science or health/healthcare related field from an accredited institution required.Certified Professional of Healthcare Quality (CPHQ), or other recognized quality improvement certificate required or within one (1) year of hire (maintained through employment).Minimum possession of one of the following active, unrestricted, and unencumbered clinical licenses required:
Registered Nurse (RN) license issued by the California BRNAdvanced clinical licensure issued by appropriate State Board (i.e. PA)
Key QualificationsMust have a valid California Driver’s license and valid automobile insurance. Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points.Working knowledge of healthcare quality performance and measurement sets including CMS quality withhold, Managed Care Accountability Set, NCQA Quality Improvement Standards and HEDIS.Ability to apply knowledge of project management techniques, tools of continuous improvement, and work process redesign.Knowledge of advanced clinical processes and/or hospital operations.Requires knowledge of the local healthcare market, patient demographics and needs and plan-specific information.Proficient in all Microsoft Office applications, with an emphasis on Excel, PowerPoint and Visio.Start your journey towards a thriving future with IEHP and apply
TODAY !
#J-18808-Ljbffr