Manager Quality Improvement

Health Care Service Corp.; Chicago (IL); Remote; USD 84,000 - 152,000; Full time

Job summary

Health Care Service Corporation (HCSC) is seeking a population health and quality improvement professional to support provider groups and care initiatives, collaborating with clinicians and internal partners. This role focuses on improving preventive care and health outcomes through data-driven strategies.

Responsibilities include embedded provider support, member outreach, care gap closure, provider education, and advancing value-based care through clinical and operational strategies that

Qualifications

• RN or PA with active license in the operating state.
• 2 years’ experience using accreditation agency programs.
• 3 years of medical surgical and/or Quality Improvement and Utilization Review experience.
• 2 years of leadership or supervisory experience.
• Knowledge of medical terminology and procedures.
• Experience in using Total Quality Management (TQM)/Continuous Quality Improvement (CQI) concepts.
• Analytical skills to analyze data and prepare reports.
• Verbal and written communications skills in preparing recommendations and written documentation in appropriate format and facilitating work groups.
• Project management experience and skills PC experience utilizing Microsoft Windows based products and database experience.

Responsibilities

• > Embedded provider support and member outreach
• > Care gap identification and closure activities
• > Provider education and quality measure improvement
• > Implementation of clinical and operational strategies to enhance preventive care and health outcomes and support value-based care objectives

Skills

RN/PA license

TQM/CQI concepts

Data analysis

Project management

Leadership

Medical terminology

Windows & databases

Verbal & written communication

Report writing

Provider education

Tools

Microsoft Windows

Database experience

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

This position is responsible for supporting population health, quality improvement, and value-based care initiatives through close collaboration with provider groups, clinicians, and internal business partners.

Responsibilities include embedded provider support, member outreach, care gap identification and closure activities, provider education, quality measure improvement, and implementation of clinical and operational strategies that enhance preventive care, improve health outcomes, and support value-based care objectives.

Required Job Qualifications

• Registered Nurse (RN) or Registered Physician Assistant (RPA) with current, unrestricted license in the state of operations.
• 2 years’ experience using accreditation agency programs.
• 3 years of medical surgical and/or Quality Improvement and Utilization Review experience.
• 2 years of leadership or supervisory experience.
• Knowledge of medical terminology and procedures.
• Experience in using Total Quality Management (TQM)/Continuous Quality Improvement (CQI) concepts.
• Analytical skills to analyze data and prepare reports.
• Verbal and written communications skills in preparing recommendations and written documentation in appropriate format and facilitating work groups.
• Project management experience and skills PC experience utilizing Microsoft Windows based products and database experience.

Preferred Job Requirements

• Experience supporting population health, preventive care, or care management initiatives within a health plan, medical group, or healthcare system.
• Experience conducting provider and member outreach to improve quality outcomes and close gaps in care.
• Demonstrated success leading individuals in improving HEDIS, STAR, quality, or performance metrics through provider engagement and operational interventions.
• Experience working within provider offices, clinics, or health systems to implement quality improvement initiatives.
• Knowledge of value-based care, risk-based contracting, and population health management strategies.
• Prior leadership of quality consultants, clinical quality specialists, practice consultants, or population health teams.
• Experience leading large-scale quality or population health initiatives across multiple markets, provider groups, or regions.
• Experience collaborating with multidisciplinary teams to improve member engagement, access to care, and health outcomes.
• The ability to speak both the clinical language of providers and the operational language of health plan leadership.
• Medicare Stars and HEDIS expertise that goes beyond reporting and includes driving measurable improvement.
• Experience reviewing and utilizing EMR data, care gap reports, and quality dashboards to drive performance improvement.
• Proven ability to build trusted relationships with physicians, practice administrators, and clinical staff.
• A track record of improving quality metrics through provider engagement rather than solely through internal analytics.
• Experience supporting practice transformation, workflow optimization, or clinical process improvement initiatives.
• Knowledge of preventive health measures, chronic disease management, and quality performance programs.

This is a fully work from home position, available in the US only, not limited to the posting location. Sponsorship is not available.

Pay Transparency Statement

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work.

From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees.

• Health and wellness benefits
• 401(k) savings plan
• pension plan
• paid time off
• paid parental leave
• disability insurance
• supplemental life insurance
• employee assistance program
• paid holidays
• tuition reimbursement
• other incentives

Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range $84,400.00 - $152,300.00 Exact compensation may vary based on skills, experience, and location.

For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families.

As an industry leader, HCSC also has been helping to make the health care system work better for all Americans.

To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities.

Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions.

We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace.

Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment.

HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.