Senior Quality Improvement Lead - Healthcare (Hybrid, LA)

Blue Shield of CA; Long Beach (CA); Hybrid; USD 110,000 - 150,000; Full time

Job summary

Blue Shield of California is seeking a Senior Program Manager, Quality Improvement to lead Medi-Cal quality initiatives. The role focuses on designing, implementing, and measuring quality interventions, toolkits, and clinic days to drive performance across HEDIS, MCAS, CAHPS, and other measures.

This hybrid, field-based position serves the Los Angeles area with regular in-office days at Long Beach/ Woodland Hills and clinic visits, requiring some evenings and Saturdays as needed.

Qualifications

• Bachelor's degree or equivalent with 4 years of relevant experience.
• 5+ years of healthcare quality improvement/quality management experience.
• 3+ years working with IPAs, medical groups, FQHCs, or Medi-Cal providers.
• Experience in project or program management.
• Knowledge of HEDIS and NCQA/DHCS requirements preferred.
• Proficiency with Cozeva application preferred.
• Tableau experience for quality reporting preferred.
• Experience reviewing medical records for service compliance.
• Experience in CA delegated model or integrated clinical delivery systems preferred.

Responsibilities

• Design, develop, and manage quality improvement interventions, toolkits, clinic days, and analytic insights.
• Collaborate with internal Quality Program Managers and cross-functional teams to execute improvement strategies.
• Support provider organizations, external vendors, and community partners to strengthen relationships.
• Align current and future QI programs with long-term organizational goals.

Skills

Quality Improvement

Project Management

Healthcare Quality

Data Analysis

Stakeholder Collaboration

Tableau

Cozeva

IPA coordination

Education

Bachelor's degree or equivalent

Tools

Cozeva

Tableau

Job description

Blue Shield of California is seeking a Senior Program Manager, Quality Improvement to lead Medi-Cal quality initiatives. The role focuses on designing, implementing, and measuring quality interventions, toolkits, and clinic days to drive performance across HEDIS, MCAS, CAHPS, and other measures.

This hybrid, field-based position serves the Los Angeles area with regular in-office days at Long Beach/ Woodland Hills and clinic visits, requiring some evenings and Saturdays as needed.