Healthcare Quality Improvement Program Lead

Blue Cross of Idaho; Meridian (ID); On-site; USD 78,000 - 117,000; Full time

Benefits offered by this job

Paid time off and holidays

Medical/dental/vision/pharmacy保险

401(k) matching

Education reimbursement

Life insurance

Job summary

Blue Cross of Idaho is seeking a Healthcare Operations professional to support quality and clinical improvement across product lines. The role involves cross-functional program coordination, vendor partnerships, and contracting activities to drive improvements and outcomes.

You will organize workgroups, coordinate vendor relationships, and monitor program performance, with a focus on HEDIS improvements and operational efficiency. A bachelor’s degree or equivalent experience is required.

Qualifications

• 5 years’ healthcare field or relevant experience.
• Education: Bachelor’s Degree or equivalent work experience (Two years’ relevant work experience is equivalent to one-year college).

Responsibilities

• Collaborate with cross-functional teams, vendors, and business partners to organize efforts and workgroups targeted at quality improvement, member outreach, provider support, clinical improvement, and related program activities.
• Coordinate vendor and contracting activities supporting quality programs, including gathering business requirements, supporting requests for proposals or services, contract renewals and amendments, and implementation of approved services in partnership with Procurement and other internal stakeholders.
• Support ongoing management of quality vendors by monitoring contractual deliverables, service commitments, timelines, issues, and program performance, and coordinating appropriate follow-up with internal and external stakeholders.
• Identify, prioritize, sequence, and recommend initiatives for HEDIS measure improvement for each line of business. Maximize the opportunity for improvement while taking into consideration cost, benefit, available resources, and return on investment.
• Identify opportunities for quality and operational improvement using annual, prospective, vendor, and program data sources.
• Coordinate implementation of approved quality initiatives and vendor-supported programs, including workplans, timelines, business requirements, stakeholder coordination, and issue resolution.
• Track program, project, and vendor outcomes and present conclusions, risks, recommendations, and opportunities to leadership.
• Support departmental planning and oversight of vendor services, including contract requirements, renewals, invoices, budgets, and anticipated program needs.
• Coordinate and support cross-functional efforts to develop and implement improvement plans and operational solutions for all applicable lines of business.
• Present program results, analysis, status, risks, and recommendations to management, steering committees, vendors, and impacted work teams.
• Ensure documentation of improvement plans, vendor activities, contractual deliverables, decisions, and program outcomes.
• Perform other duties and responsibilities as assigned.

Skills

Healthcare experience

Education

Bachelor's degree or equivalent

Job description

Blue Cross of Idaho is seeking a Healthcare Operations professional to support quality and clinical improvement across product lines. The role involves cross-functional program coordination, vendor partnerships, and contracting activities to drive improvements and outcomes.

You will organize workgroups, coordinate vendor relationships, and monitor program performance, with a focus on HEDIS improvements and operational efficiency. A bachelor’s degree or equivalent experience is required.