Senior Medi-Cal Quality Improvement Lead

Blue Shield of California; California; Hybrid; USD 91,000 - 136,000; Full time

Job summary

Blue Shield of California is seeking a Program Manager, Senior, Quality Improvement to design and manage Medi-Cal quality initiatives, driving improvements across HEDIS, MCAS, CAHPS, NCQA health plan ratings, DMHC metrics, and Medicaid QRS by collaborating with internal Quality Program Managers, provider organizations, external vendors, and community partners.

This hybrid field-based role serves the Los Angeles area, with in-office days in Long Beach or Woodland Hills and occasional clinic

Qualifications

• Bachelor’s degree or High School Diploma/GED with 4 years of additional relevant experience.
• Minimum of 5 years of healthcare experience in Quality Improvement/Quality Management with demonstrated improvement skills.
• 3 years experience with IPAs, medical groups, FQHCs, or Medi-Cal providers.
• Strong project/program management experience.
• Knowledge of HEDIS and accrediting bodies (NCQA, DHCS) desired.

Responsibilities

• Plan, execute, and evaluate large, complex quality initiatives to improve Medi-Cal performance.
• Develops measurement strategies for large change initiatives.
• Lead programs from pilot to delivery and spread, with continuous improvement.
• Be an expert on quality initiatives and policies to guide internal teams.
• Lead interventions to improve HEDIS, MCAS, CAHPS, NCQA ratings, DMHC HEQMS, and Medicaid QRS.

Skills

Quality Improvement

Project Management

Healthcare Provider Collaboration

Strategic Thinking

Stakeholder Engagement

Education

Bachelor’s degree or High School Diploma/GED with 4 years of relevant experience

Tools

Cozeva

Tableau

Job description

Blue Shield of California is seeking a Program Manager, Senior, Quality Improvement to design and manage Medi-Cal quality initiatives, driving improvements across HEDIS, MCAS, CAHPS, NCQA health plan ratings, DMHC metrics, and Medicaid QRS by collaborating with internal Quality Program Managers, provider organizations, external vendors, and community partners.

This hybrid field-based role serves the Los Angeles area, with in-office days in Long Beach or Woodland Hills and occasional clinic