Manager - Quality Care Improvement Department: Value-Based Care Programs Employment Type: Full Time Location: Remote Reporting To: Tahira Hashmi Compensation: $105,000 - $130,000 / year Description Astrana is seeking a M…
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$105k–$130k/yr
Full-time
bachelor degree, postgraduate degree
Posted 3d ago
~40 hrs/week
Remote in United States
Responsibilities
Lead quality initiatives and regional operations, overseeing the execution of HEDIS and Medicare Star Ratings programs. Act as a key liaison between health plans, IPA partners, and providers to drive quality performance and compliance.
Requirements
Requires a bachelor's degree (Master's preferred) with at least 5 years of quality/HEDIS experience and 2 years of supervisory experience. Must possess strong knowledge of NCQA technical specifications and value-based programs.
Full job description
Manager - Quality Care Improvement
Department: Value-Based Care Programs
Employment Type: Full Time
Location: Remote
Reporting To: Tahira Hashmi
Compensation: $105,000 - $130,000 / year
Description
Astrana is seeking a Manager - Quality Improvement to be responsible for leading quality initiatives and teams within the Quality Department. This role has direct oversight over regional operations for quality related activities including supervision of staff, design/deployment of activities, and managing external partner relationships such as health plans and providers. The manager oversees assigned programs, projects, and lines of business, ensuring effective coordination and execution of HEDIS and Medicare Star Ratings initiatives. This role serves as a key liaison between Astrana Health, health plans, IPA partners, and providers to drive quality performance and compliance.
Our Values:
Put Patients First
Empower Entrepreneurial Provider and Care Teams
Operate with Integrity & Excellence
Be Innovative
Work As One Team
What You'll Do
The Manager - Quality Improvement is responsible for leading quality initiatives and teams within the Quality Department. This role has direct oversight over regional operations for quality related activities including supervision of staff, design/deployment of activities, and managing external partner relationships such as health plans and providers. The manager oversees assigned programs, projects, and lines of business, ensuring effective coordination and execution of HEDIS and Medicare Star Ratings initiatives. This role serves as a key liaison between Astrana Health, health plans, IPA partners, and providers to drive quality performance and compliance. ESSENTIAL DUTIES AND
Leadership and oversight over day-to-day operations for designated areas
Oversee health plan metrics and ratings including identifying, addressing gaps in performance
Collaborate with peers within assigned regions and across the organization to deploy effective programs for quality gap closures
Lead health plan, IPA and provider meetings to review KPIs, share best practices and design process improvement activities to improve outcomes
Manage quality data workflows between Astrana and health plans to ensure complete and accurate submission of relevant data
Support audits requested by payers or other partners to meet compliance requirements • Able to prioritize work to reach overall team goals
Be detail oriented and show strong organizational skills.
Drive outcomes for critical measures assigned to other departments through cross functional teamwork and support
Able to analyze key trends and succinctly communicate findings to leadership, providers, health plans
Able to identify barriers or risks early and escalate to leadership for support and intervention
Manage a team remotely to execute on provider engagement and execution of key initiatives
Hire, retain, mentor, and manage performance for direct reports through a culture of accountability, collaboration, and continuous improvement.
Ensure all work completed meets internal compliance requirements as well as health plan and NCQA compliance.
Be responsible for assigned health plans including managing ongoing relationships with key individuals, attending meetings, and providing updated presentations among other required tasks.
Participate in staff hiring efforts and evaluation of performance during introductory period and annually
Maintain a professional demeanor at all times with both internal and external stakeholders, including being timely in responses, delivering exceptional customer service, and maintaining clear communication.
Performance manage direct reports as appropriate and with guidance from HR and department leaders
Attend regional meetings in person or remotely depending on business needs
Able to present to large groups of providers or team members including managing Q/A
Be a subject matter expert in NCQA guidelines for quality measures and able to direct providers to address gap closures within these parameters.
Performs other duties, projects and actions assigned in a professional manner, utilizing time and resources efficiently.
Qualifications
Minimum of BA/BS degree or equivalent work experience
Master’s Degree highly preferred
5+ years of quality/HEDIS work experience; 2+ years of supervisory/management experience required
Strong knowledge of value-based programs and managed care operations
Subject matter expert in NCQA technical specifications or demonstrated ability to access this information
Excellent oral and writing skills are characterized by the ability to communicate effectively with audiences at all levels
Excellent analytical critical reasoning and interpersonal communication skills
Must be ethical and possess the ability to remain impartial and objective
At least intermediate skills in MS Excel and PowerPoint
Good organization, critical thinking, and problem-solving skills
Environmental Job Requirements and Working Conditions
This is a full-time, remote position. Candidates must be able to travel up to 25% of the time to assigned regions and able to travel to corporate offices as needed. The office is located at 1600 Corporate Center Drive in Monterey Park, CA.
The national target pay range for this position is $105,000 - $130,000 per year. Actual compensation will be based on experience, geographic location (current or future), and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at [email protected]to request an accommodation.
Empowering physicians and providers to deliver high-quality, patient-centered care to all. (NASDAQ:ASTH)
Industry
Hospitals and Health Care
Company size
1,001-5,000 employees
Headquarters
Alhambra, California
LinkedIn followers
19,582
Total funding
$334M
Astrana Health is a physician-centric, technology-enabled healthcare company committed to delivering access to high-quality, patient-centered care. Through its proprietary end-to-end technology platform, Astrana empowers providers to deliver more proactive, preventive care - improving patient outcomes, elevating patient experiences, improving the well-being of providers, and driving greater value.
Today, Astrana supports more than 20,000 providers and over 1.6 million Americans in value-based arrangements through its affiliated provider networks, management services organization, and primary, specialty, and ancillary care delivery clinics.
Together, Astrana is building what our healthcare system should be - one that delivers better care, better experiences, and better outcomes for all. For more information, visit www.astranahealth.com.
Offices: Alhambra, California 91801, US · Las Vegas, Nevada 89148, US
Empowering physicians and providers to deliver high-quality, patient-centered care to all. (NASDAQ:ASTH)
Industry
Hospitals and Health Care
Company size
1,001-5,000 employees
Headquarters
Alhambra, California
LinkedIn followers
19,582
Total funding
$334M
Astrana Health is a physician-centric, technology-enabled healthcare company committed to delivering access to high-quality, patient-centered care. Through its proprietary end-to-end technology platform, Astrana empowers providers to deliver more proactive, preventive care - improving patient outcomes, elevating patient experiences, improving the well-being of providers, and driving greater value.
Today, Astrana supports more than 20,000 providers and over 1.6 million Americans in value-based arrangements through its affiliated provider networks, management services organization, and primary, specialty, and ancillary care delivery clinics.
Together, Astrana is building what our healthcare system should be - one that delivers better care, better experiences, and better outcomes for all. For more information, visit www.astranahealth.com.
Offices: Alhambra, California 91801, US · Las Vegas, Nevada 89148, US