Quality Improvement Program Manager

Health Partners Plans, Inc.; Jefferson Center (PA); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life and AD&D insurance

Short- and long-term disability

Flexible spending accounts

Tuition assistance

Retirement plans

Job summary

Health Partners Plans, Inc. is seeking a Quality Improvement (QI) Program Manager to coordinate and support quality initiatives across all lines of business.

The role oversees care gap closure, in-home appointment campaigns, and regulatory reporting support, while maintaining quality dashboards and work plans. The incumbent partners with clinical, operational, vendor, provider, and regulatory teams to improve quality outcomes, member experience, and compliance.

Qualifications

• Bachelor’s Degree.
• 2 years working experience in project management required.
• Strong problem-solving, quantitative and analytical skills required.
• Proficient use of Microsoft Office suite (Word, Power Point, Excel) required.
• Strong project management and organizational skills with the ability to manage multiple priorities simultaneously.
• Excellent organizational, interpersonal and time management skills required.
• Ability to organize and manage multiple priorities.
• Ability to work independently and as part of a team.
• Detail-oriented with strong follow-through and accountability.
• Excellent written and verbal communication skills.
• Flexibility is required to deal with diverse situations and a changing environment.
• Ability to quickly learn and implement knowledge of new business processes required.

Responsibilities

• Coordinate and support quality improvement activities designed to improve performance on regulatory and accreditation measures, including HEDIS, Medicare Advantage Stars, Medicaid quality programs, and state-specific initiatives.
• Provide operational oversight for vendor-led in-home appointment campaigns and community events, including member data file creation, secure data transfer, and performance tracking
• Track outreach activities, appointment completion rates, and event outcomes to ensure performance targets are met.
• Support the Regulatory and Quality Reporting teams with preparation, validation, and submission of required reports to the Department of Human Services (DHS), CMS, NCQA, and other regulatory agencies.
• Design, maintain, and update quality dashboards, scorecards, and performance tracking reports in collaboration with Analytics and Reporting teams.
• Monitor progress toward organizational quality goals and elevate risks or gaps to leadership.
• Partner with clinical leadership, analytics, provider relations, operations, population health, and regulatory teams to support enterprise quality goals.

Skills

Project management

Analytical skills

Microsoft Office

Communication

Team collaboration

Education

Bachelor’s Degree

Tools

Microsoft Office

Job description

Job Details

The Quality Improvement (QI) Program Manager is responsible for coordinating and supporting quality improvement initiatives across all lines of business within the health plan. This role oversees operational activities related to care gap closure, member outreach events, in-home appointment scheduling, regulatory quality reporting support, and maintenance of quality performance dashboards and work plans. The Program Manager partners closely with clinical, operational, vendor, provider, and regulatory teams to improve quality outcomes, member experience, and regulatory compliance.

Job Description Summary

The Quality Improvement (QI) Program Manager is responsible for coordinating and supporting quality improvement initiatives across all lines of business within the health plan. This role oversees operational activities related to care gap closure, member outreach events, in-home appointment scheduling, regulatory quality reporting support, and maintenance of quality performance dashboards and work plans. The Program Manager partners closely with clinical, operational, vendor, provider, and regulatory teams to improve quality outcomes, member experience, and regulatory compliance.

Job Duties

• Coordinate and support quality improvement activities designed to improve performance on regulatory and accreditation measures, including HEDIS, Medicare Advantage Stars, Medicaid quality programs, and state-specific initiatives.
• Provide operational oversight for vendor-led in-home appointment campaigns and community events, including member data file creation, secure data transfer, and performance tracking
• Track outreach activities, appointment completion rates, and event outcomes to ensure performance targets are met.
• Support the Regulatory and Quality Reporting teams with preparation, validation, and submission of required reports to the Department of Human Services (DHS), CMS, NCQA, and other regulatory agencies.
• Design, maintain, and update quality dashboards, scorecards, and performance tracking reports in collaboration with Analytics and Reporting teams.
• Monitor progress toward organizational quality goals and elevate risks or gaps to leadership.
• Partner with clinical leadership, analytics, provider relations, operations, population health, and regulatory teams to support enterprise quality goals.

Minimum Qualifications

• Bachelor’s Degree
• 2 years working experience in project management required
• Strong problem-solving, quantitative and analytical skills required
• Proficient use of Microsoft Office suite (Word, Power Point, Excel) required
• Strong project management and organizational skills with the ability to manage multiple priorities simultaneously
• Excellent organizational, interpersonal and time management skills required
• Ability to organize and manage multiple priorities.
• Ability to work independently and as part of a team.
• Detail-oriented with strong follow-through and accountability.
• Excellent written and verbal communication skills.
• Flexibility is required to deal with diverse situations and a changing environment.
• Ability to quickly learn and implement knowledge of new business processes required.

Additional Qualifications

Physical Demands Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.

Job Description Disclaimer

This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.

Work Shift

Workday Day (United States of America) Worker Sub Type Regular Employee Entity Health Partners Plans, Inc.

Primary Location

1101 Market, Philadelphia, Pennsylvania, United States of America

Company Overview

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research.

Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students.

Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region.

Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Benefits

• Benefits Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts.
• Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service.
• All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

Mission Statement

In keeping with Jefferson's Mission, We Improve Lives, it is our goal to recruit, retain, develop and reward highly-qualified employees. If you are enthusiastic, caring and dedicated to service excellence, we invite you to consider joining Jefferson. Jefferson encourages its employees to expand their knowledge and develop their careers through growth opportunities and continuing education. With a long standing history, Jefferson has been advancing the medical field from the heart of Center City Philadelphia for nearly 200 years. Our Mission, We Improve Lives, expands to every corner of the organization. From our weekly farmer’s market, to our new Jefferson Accelerator Zone for innovation, our employees’ passion for the community is evident by the daily gestures towards our patients, students and each other.