Manager of Quality Improvement Programs

Job Summary

A company is looking for a Manager, Stars and Quality Improvement Programs.

Key Responsibilities

• Lead and manage quality initiatives for the Medicare Advantage line of business, focusing on CMS Star Ratings and HEDIS performance
• Coordinate HEDIS reporting and audits, ensuring data validation and compliance with NCQA standards
• Manage and mentor the Quality and Performance Improvement team while collaborating across various departments to enhance quality outcomes

Required Qualifications

• Bachelor's degree in nursing, Public Health, Healthcare Administration, or related field (master's preferred)
• Minimum 7 years of experience in healthcare quality improvement, preferably in managed care or Medicare Advantage
• Strong knowledge of HEDIS, MIPS, NCQA, and CMS Star Ratings
• Hands-on experience with the HEDIS audit process and quality measure analysis
• Proven ability to manage cross-functional teams and lead complex quality projects