Manager Health Plans Quality - US Family Health Plan

Christus Health; Irving (TX); On-site; USD 90,000 - 120,000; Full time

Job summary

Christus Health is seeking a proactive professional to design and manage training strategies for HEDIS processes, ensuring operational milestones and quality standards are met across teams.

You will create and maintain program descriptions, evaluations, and workplans year over year, while coordinating with QA and external vendors to drive program success and regulatory compliance.

Qualifications

• Bachelor's in health administration, informatics nursing, nursing or related clinical field required in lieu of RN licensure
• Masters in public policy - Administration, Nursing informatics, MBA, MPH or MPA preferred

Responsibilities

• Create dashboards and use SPSS, Qualtrics or similar software to analyze monthly output/input
• Collaborate with Patient Safety to produce adhoc reports and support teamwork
• Manage program descriptions, evaluations, workplans and CAHPs reporting (PD/PE & CQMP & CQMP AR)
• Assist HEDIS team to facilitate and coordinate training, training understanding, and workflow processes
• Develop training materials for HEDIS software training and admin/hybrid measure training
• Coordinate training for external client programs and develop program success measures and assessments
• Ensure compliance with corporate QI work plans
• Communicate effectively and collaborate across departments and vendors
• Document research programs to meet regulatory and Accreditation Standards
• Provide oversight for quantitative analysis of clinical data and presentation of results
• Participate in development of new product designs for major lines of business
• Lead implementation of new initiatives and interactions with regulators
• Oversee quality improvement activities for large health plan partners' programs

Skills

Bachelor's degree in health admin

Nursing informatics

Healthcare quality

Data analysis

Project management

Education

Bachelor's in health administration

Masters in public policy, Administration, Nursing informatics, MBA, MPH or MPA

Tools

SPSS

Qualtrics

Job description

Description

Summary:

Responsible for creating and facilitation training strategies/programs to support an operational team responsible for working closely with and understanding the process of abstraction and pursuit of HEDIS measures to ensure that operational milestones, gap closures, rates, and overall successful quality standards are met. Equally responsible for all program descriptions, evaluations and workplans being created and managed year over year.

Responsibilities:

• Must be able to create dashboards, use SPSS, Qualtrics or similar software programs to create appropriate analysis of monthly output/input


• Work with Patient Safety to produce adhoc reports; must be a true team player and willing to go the extra mile


• Handle all program descriptions, evaluations workplans and CAHPs reporting. (i.e. PD/PE & CQMP &CQMP AR).


• Assist HEDIS team to facilitate and coordinate HEDIS training, technical training understanding, and workflow processes,


• Be knowledgeable of HEDIS software training, admin and hybrid measure training and creating training materials


• Coordinates training related to external client facing program; develops program success measures and performs periodic assessments of program success.


• Assures compliance with corporate QI work plan.


• Must be a good writer, communicator and possess the skills to get along with others.


• Assures that all QI activities are relevant to the needs of targeted population.


• Work collaboratively with various departments, vendors, internal/external, when necessary to leverage our resources effectively


• Maintains effective documentation of research programs to meet regulatory and Accreditation Standards.


• Provides oversight to assure accurate and complete quantitative analysis of clinical data and presentation of data analysis results.


• Participates in and provides input to the development of new product designs for major line of business.


• Oversees the implementation of new initiatives.


• Leads interactions with regulators or oversight entities.


• Oversees quality improvement activities for the largest, most complex health plan partners' programs.

Requirements:

Education/Skills

• Bachelor's in health administration, Informatic nursing, nursing or a related clinical field required in lieu of RN licensure


• Masters in public policy - Administration, Nursing informatics, MBA, MPH or MPA preferred

Experience

• 4 years of health care quality or data analysis experience.


• 5-7 years of HEDIS experience, or any combination of education and experience, which would provide an equivalent background that shows proficiency.


• Project management knowledge with deep understanding if certification is not present preferred


• Program management with at least 2 plus years of experience preferred

Licenses, Registrations, or Certifications

• RN Licensure required in lieu of Bachelor's degree

Work Schedule:

5 Days - 8 Hours

Work Type:

Full Time