Manager Clinical Quality Improvements

Commonspirit; Bakersfield (CA); Remote; USD 80,000 - 100,000; Full time

Job summary

An established industry player is seeking a Manager for Clinical Quality Improvement to lead transformative initiatives across health care systems. This role involves collaborating with various departments to enhance quality metrics and ensure compliance with regulatory standards. The ideal candidate will have extensive experience in quality management, a clinical background, and strong leadership skills. Join a forward-thinking organization that values innovation and continuous improvement, offering a competitive pay package and a supportive work environment. This is an exciting opportunity to make a significant impact in the health care sector while working remotely within California.

Benefits

Flexible benefits (medical, dental, vision)

401k plan with employer match

Paid Time Off

Sick Leave

Life insurance

Long-term disability

Qualifications

• 5+ years of Quality Management experience in managed care.
• CA Clinical licensure required (RN, LVN, etc.).

Responsibilities

• Lead quality improvement initiatives across Medicare and Medicaid.
• Monitor results aligned with strategic goals.

Skills

Quality Management

Leadership

Data Analysis

Regulatory Standards

HEDIS Measures Reporting

Education

Bachelor’s degree in health sciences or related field

Master’s degree (MPH, MPA, MA)

Tools

Dashboards

Quality Metrics Tools

Job description

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• This position is remote/work from home within California.*
  
  

*Responsibilities

• This position will lead a team of dedicated LVNs/RNs in support of organizational quality improvement initiatives across Medicare, Medicaid and Commercial space. He/She will partner with other departments, health plans and providers to develop and monitor quality improvement plans, and report out to leaders. This position offers the opportunity to engage at both local and system/national levels in the population health space.

Position Summary

The Manager, Clinical Quality Improvement, is responsible for leading large-scale, organization-wide quality improvement initiatives. This includes negotiating project timelines and priorities, coordinating action plans, and monitoring results aligned with strategic goals. The manager will oversee day-to-day department management, act as a liaison between medical groups and contracted health plans, and collaborate organization-wide to establish quality improvement programs.

Responsibilities May Include

• Interpret, implement, and maintain regulatory standards (e.g., DMHC, DHCS, CMS, NCQA).
• Stay updated on quality measures and industry best practices to enhance performance.
• Create or update Policies and Procedures for compliance.
• Identify improvement opportunities and lead sustainability of initiatives.
• Perform data analysis to inform actions based on insights.
• Develop dashboards and tools to track quality metrics (Provider Score Cards, Gaps in Care reports).
• Design workflows, disseminate data, and promote shared learning.
• Perform other duties and special projects as assigned.

Qualifications

Minimum Qualifications

• CA Clinical licensure (RN, LVN, LCSW, NP, PA).
• 5 years of Quality Management experience in managed care or medical group settings.
• 5 years of supervision/leadership of clinical and non-clinical staff.
• 3 years of HEDIS measures reporting and experience with CMS Stars, P4P, ACO, and Value-Based Payment programs.
• 3 years managing medical record review projects.
• Bachelor’s degree or equivalent in health sciences or related field.

Preferred Qualifications

• 2 years clinical experience in acute care, long-term care, or home health (preferred).
• Master’s degree (MPH, MPA, MA) (preferred).
• Certification in Healthcare Quality (CHCQM) or CPHQ (preferred).
• LEAN or Six Sigma Green Belt (preferred).

Overview

This position is remote/work from home within California.*

Dignity Health MSO aims to build a system-wide, physician-centric management organization, providing comprehensive services that leverage economies of scale and develop population health pathways. We prioritize quality, cost containment, and continuous improvement through industry-leading technology and local resources.

Our Total Rewards package includes competitive pay, flexible benefits (medical, dental, vision, HSA, life insurance, long-term disability), a 401k plan with employer match, Paid Time Off, and Sick Leave.

Pay Range

$40.66 - $58.96/hour

Additional Information

• Seniority level: Not Applicable
• Employment type: Full-time
• Job function: Health Care Provider
• Industries: Wellness and Fitness Services, Hospitals and Healthcare, Medical Practices