Healthcare Quality Improvement Leader

Altais Health Solutions; California; Hybrid; USD 107,000 - 129,000; Full time

Benefits offered by this job

Excellent medical, vision, and dental

401k with company match

Flexible time off

9 Paid Holidays

Job summary

Altais Health Solutions seeks a Clinical Quality Advisor to direct multi-department programs, support quality improvement, analyze performance data, and implement initiatives based on industry best practices. This role focuses on developing and implementing cross-functional projects, ensuring timely delivery and continuous improvements.

You will collaborate with stakeholders to enhance CMS Star Ratings, HEDIS, CAHPS outcomes; lead training, governance, and milestone tracking while delivering

Qualifications

• Bachelor’s degree or equivalent experience.
• Minimum 8 years of prior relevant experience in managed care quality improvement, care management or clinical program management in a clinical/healthcare environment.
• MSO/IPA or Health Plan population health management or quality experience.
• Working knowledge of HEDIS, CAHPS, HOS, CMS Medicare Star Ratings, P4P programs, CMS quality withhold, MCAS and NCQA Quality Improvement standards.
• Specific licensing requirements may apply (e.g., LVN, RN, NP, PA, MSW, CPhT).

Responsibilities

• Targeted improvement activities to enhance CMS Star Ratings, HEDIS, CAHPS and other measures.
• Research evidence-based practices and national benchmarks; integrate findings into initiatives.
• Monitor improvement activities and provide actionable feedback to management.
• Lead performance improvement methodologies and rapid-cycle initiatives.
• Support development and maintenance of quality improvement program documents.
• Provide training on quality improvement tools and methodologies to stakeholders.
• Organize interdepartmental activities and track milestones and governance.

Skills

Quality improvement

Care management

Clinical program mgmt

CMS Star Ratings

HEDIS knowledge

Licensure options

Education

Bachelor’s degree or equivalent experience

Job description

Altais Health Solutions seeks a Clinical Quality Advisor to direct multi-department programs, support quality improvement, analyze performance data, and implement initiatives based on industry best practices. This role focuses on developing and implementing cross-functional projects, ensuring timely delivery and continuous improvements.

You will collaborate with stakeholders to enhance CMS Star Ratings, HEDIS, CAHPS outcomes; lead training, governance, and milestone tracking while delivering