Manager, Quality Performance and Outreach – STARS, CAHPS, PWP, HEDIS

Job Description:

• Play a critical role in driving strategic initiatives to improve STARS, CAHPS, PWP, and HEDIS performance across the health plan and enterprise.
• Lead cross-functional efforts to design, implement, and evaluate outreach and quality improvement programs that enhance member experience, close care gaps, and support regulatory compliance.
• Focus on all lines of business, including Commercial, Medicaid, and Medicare, collaborating with other health plan departments, providers, vendors, and the enterprise.
• Manage a Team of 4 Direct Reports.

Requirements:

• Bachelor’s degree in Nursing, Clinical Sciences, Population Health, Healthcare Administration, Business Administration, or related field REQUIRED
• Registered Nurse License in Virginia OR Compact/Multi-state preferred
• 3 years of experience with HEDIS, STARS, PWP, or Clinical Improvement REQUIRED
• 3 years of supervisory or management experience REQUIRED
• Prior experience in Project Management and Performance Improvement preferred
• Strong project management and cross-functional collaboration skills REQUIRED
• Ability to interpret clinical data and translate insights into actionable strategies REQUIRED
• Experience working with vendors and managing outreach campaigns REQUIRED
• Health Plan experience is preferred.

Benefits:

• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down – $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.

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