Senior Clinical Quality & Performance Manager

L.A. Care Health Plan; Los Angeles (CA); On-site; USD 102,000 - 163,000; Full time

Benefits offered by this job

PTO

Tuition Reimbursement

Retirement Plans

Medical/Dental/Vision

Wellness Program

Job summary

L.A. Care Health Plan in Los Angeles, CA is seeking a Clinical Quality Program Manager III to lead quality initiatives within CMS Five-Star and QRS metrics. You will strategize and manage programs, oversee vendor contracts, and collaborate with multiple departments to drive enterprise-quality goals.

The role requires strong analytics, communication, and leadership to improve CAHPS/HOS/HEDIS metrics and elevate patient care across the network.

Qualifications

• 5+ years in a health plan focusing on quality, informatics, QI initiatives and analytics.
• Experience in implementing initiatives to improve quality ratings and manage projects end to end.
• Experience with CAHPS/HOS/HEDIS or similar quality metric domains is preferred.

Responsibilities

• Lead Core Teams by leveraging technology to streamline processes, enhance collaboration and transparency.
• Coordinate across QI, Pharmacy, Care Management, Utilization Management, Risk Adjustment and provider network.
• Manage SharePoint sites and ensure regulatory guidance is accessible and documented.
• Organize workgroup meetings, agendas, minutes and action items.
• Partner with Analytics to drive quality reporting and improvement initiatives.

Skills

Quality ratings

Data analysis

Attention to detail

MS Office

Data presentation

Communication

Critical thinking

Team player

Education

Bachelor's Degree

Master's Degree preferred

Tools

SharePoint

Job description

L.A. Care Health Plan in Los Angeles, CA is seeking a Clinical Quality Program Manager III to lead quality initiatives within CMS Five-Star and QRS metrics. You will strategize and manage programs, oversee vendor contracts, and collaborate with multiple departments to drive enterprise-quality goals.

The role requires strong analytics, communication, and leadership to improve CAHPS/HOS/HEDIS metrics and elevate patient care across the network.