Health Plan Quality Administrator, Michigan

McLaren; Flint (MI); On-site; USD 70,000 - 95,000; Full time

Job summary

McLaren Health Plan (MHP) seeks a Quality Administrator to drive quality improvement initiatives and coordinate regulatory activities. You will present updates to quality staff and committees, help design targeted actions, and oversee HEDIS, NCQA, CAHPS and state projects.

The role requires a bachelor’s degree in health care, business, or related field and 4+ years in regulated health care or managed care with quality management experience. Full‑time schedule in Michigan with on‑site duties.

Qualifications

• Bachelor's degree in health care, business or related field.
• Four years' experience in a government regulated health org or managed care with 2+ years in quality management (HEDIS/NCQA).

Responsibilities

• Provide updates to MIG quality staff and committees on recommendations and actions.
• Coordinate development and implementation of quality interventions and operations.
• Oversee regulatory and contractual responsibilities including HEDIS, NCQA, state projects, audits.

Skills

Quality management

HEDIS

NCQA

Regulated health care experience

Education

Bachelor's degree in health care, business or related field

Master's degree in health care related field

Job description

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Quality Administrator, to join in leading the organization forward.

MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA).

MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.

Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org

Position Summary:

Responsible for routinely providing updates to all MIG quality staff and the applicable Quality Committees concerning recommendations and suggested courses of action pertinent to the efficient operation of the Quality Improvement Performance Plan (QPIP). Responsible for proposing targeted actions, aiding in the development of the interventions and coordinating the implementation of all quality operations. Coordinates specific regulatory and contractual responsibilities of assigned HMO including, but not limited to, HEDIS, CAHPS, NCQA Standard compliance, state performance projects, site audits and any other regulatory agencies.

Qualifications

Required:

• Bachelor's degree in health care, business or a related field.
• Four (4) years' experience with a government regulated health organization or a managed care setting with at least two (2) years' experience performing complex quality management activities including HEDIS, NCQA etc.

Preferred:

• Master's degree in health care related field.
• 6 (six) years' experience with a government regulated health organization or a managed care setting with at least three (3) years' experience performing complex quality management activities including HEDIS, NCQA etc.
• Recent related work experience at an established HMO.
• Additional Information
• Schedule: Full-time
• Requisition ID: 26002954
• Daily Work Times: 8:30 am - 5:00 pm
• Hours Per Pay Period: 80
• On Call: No
• Weekends: No