Quality Improvement Program Manager - St. Luke's Health Plan

St. Luke's Health System; Boise (ID); On-site; USD 95,000 - 125,000; Full time

Benefits offered by this job

On-site massages

On-site counseling

Wellness tools access

Career development opportunities

Job summary

St. Luke’s Health System is seeking a Quality Improvement Program Manager to lead and coordinate the Health Plan’s Quality Improvement Program and accreditation activities.

The role manages the annual QI Work Plan, tracks opportunities for improvement, and supports NCQA accreditation, quality reporting, and initiatives that improve member outcomes and plan performance. You will work with accreditation, quality reporting, Stars, provider network, customer service, utilization management,

Qualifications

• Bachelor's degree or equivalent experience.
• 4 years of relevant healthcare quality experience.

Responsibilities

• Lead and coordinate the Health Plan’s Quality Improvement Program.
• Manage annual QI Work Plan and NCQA accreditation activities.
• Track improvement opportunities and implement PDSA cycles.
• Support quality reporting, regulatory audits, and documentation readiness.
• Collaborate with cross-functional teams to improve member outcomes.
• Prepare reports and performance summaries for leadership.
• Ensure alignment with accreditation requirements and regulatory deadlines.

Skills

Quality Improvement

PDSA cycles

Regulatory knowledge

Project management

Data interpretation

Education

Bachelor's degree

Job description

At St. Luke’s, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke’s is truly a great place to work.

We are seeking a Quality Improvement Program Manager to join our team. As our Quality Improvement Program Manager, you will lead and coordinate the Health Plan's Quality Improvement Program and accreditation activities. This role is responsible for managing the annual QI Work Plan, tracking opportunities for improvement, supporting NCQA accreditation, quality reporting requirements, and facilitating initiatives that improve member outcomes, member experience, and overall plan performance. Working closely with accreditation, quality reporting, Stars, provider network, customer service, utilization management, analytics, and vendor partners, you will help translate insights into measurable results and support continuous improvement across the organization.

What You Can Expect

• Lead coordination of the Health Plan Quality Improvement (QI) Program, including management of the annual QI Work Plan, NCQA accreditation requirements, committee activities, annual program evaluation, and oversight of improvement activities and supporting documentation throughout the year.
• Identify, prioritize, and facilitate opportunities for improvement, including development, implementation, and evaluation of interventions and PDSA (Plan-Do-Study-Act) cycles.
• Support annual quality reporting activities, including project plan management, milestone tracking, measure reporting readiness, and quality review of medical record abstraction and overread activities.
• Maintain regulatory and audit readiness documentation and support internal and external reviews related to quality programs, accreditation, and reporting requirements.
• Assist with oversight of chronic care improvement initiatives, including monitoring performance, evaluating outcomes, implementing interventions, and supporting regulatory requirements.
• Prepare reports, presentations, committee materials, and performance summaries that communicate program results, improvement opportunities, intervention outcomes, and accreditation-related activities.
• Partner with quality, operational, analytics, and vendor teams to support quality improvement initiatives and advance organizational goals.

Qualifications

• Education: Bachelor's degree or experience in lieu of.
• Experience: Four (4) years' relevant experience.

Preferred Qualifications

• Knowledge of NCQA Health Plan Accreditation standards, Quality Improvement requirements, and quality program governance.
• Experience in health plan quality improvement, population health, healthcare quality management, or healthcare performance improvement.
• Experience supporting quality measure reporting, regulatory audits, accreditation activities, and performance improvement initiatives.
• Experience using healthcare data, quality metrics, and performance reporting to identify opportunities and measure improvement outcomes.
• Project management experience coordinating multiple workstreams, stakeholders, and regulatory deadlines.
  

Requirements

At St. Luke’s, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke’s is truly a great place to work.

We are seeking a Quality Improvement Program Manager to join our team. As our Quality Improvement Program Manager, you will lead and coordinate the Health Plan's Quality Improvement Program and accreditation activities. This role is responsible for managing the annual QI Work Plan, tracking opportunities for improvement, supporting NCQA accreditation, quality reporting requirements, and facilitating initiatives that improve member outcomes, member experience, and overall plan performance. Working closely with accreditation, quality reporting, Stars, provider network, customer service, utilization management, analytics, and vendor partners, you will help translate insights into measurable results and support continuous improvement across the organization.

What You Can Expect

• Lead coordination of the Health Plan Quality Improvement (QI) Program, including management of the annual QI Work Plan, NCQA accreditation requirements, committee activities, annual program evaluation, and oversight of improvement activities and supporting documentation throughout the year.
• Identify, prioritize, and facilitate opportunities for improvement, including development, implementation, and evaluation of interventions and PDSA (Plan-Do-Study-Act) cycles.
• Support annual quality reporting activities, including project plan management, milestone tracking, measure reporting readiness, and quality review of medical record abstraction and overread activities.
• Maintain regulatory and audit readiness documentation and support internal and external reviews related to quality programs, accreditation, and reporting requirements.
• Assist with oversight of chronic care improvement initiatives, including monitoring performance, evaluating outcomes, implementing interventions, and supporting regulatory requirements.
• Prepare reports, presentations, committee materials, and performance summaries that communicate program results, improvement opportunities, intervention outcomes, and accreditation-related activities.
• Partner with quality, operational, analytics, and vendor teams to support quality improvement initiatives and advance organizational goals.

Qualifications

• Education: Bachelor's degree or experience in lieu of.
• Experience: Four (4) years' relevant experience.

Preferred Qualifications

• Knowledge of NCQA Health Plan Accreditation standards, Quality Improvement requirements, and quality program governance.
• Experience in health plan quality improvement, population health, healthcare quality management, or healthcare performance improvement.
• Experience supporting quality measure reporting, regulatory audits, accreditation activities, and performance improvement initiatives.
• Experience using healthcare data, quality metrics, and performance reporting to identify opportunities and measure improvement outcomes.

• Project management experience coordinating multiple workstreams, stakeholders, and regulatory deadlines.
  

What’s in it for you:

We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Personify Health Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals.

• competitive salary and retirement plans
• medical, dental, and vision offerings
• financial and physical wellness options
• on-site massages
• on-site counseling via our Employee Assistance Program
• access to the Personify Health Wellness tool
• other formal training and career development offerings to ensure you are meeting your career goals

St. Luke’s is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law.

*Please note: this posting is not reflective of all job duties and responsibilities and is intended to provide an overview to job seekers.