Manager, Quality Performance and Outreach (STARS/ CAHPS/ PWP/ HEDIS)- Remote
City/State
Norfolk, VA
Work Shift
First (Days)
Overview:
ā¢ The Manager, Quality Performance and Outreach plays a critical role in driving strategic initiatives to improve STARS, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Performance Withold Program (PWP), and Healthcare Effectiveness Data and Information Set (HEDIS) performance across the health plan and enterprise.
ā¢ Reporting directly to the Director, Quality Performance and Outreach, this position leads cross-functional efforts to design, implement, and evaluate outreach and quality improvement programs that enhance member experience, close care gaps, and support regulatory compliance.
ā¢ The position focuses on all lines of business, including Commercial, Medicaid, and Medicare, collaborating with other health plan departments, providers, vendors and the enterprise.
ā¢ The position will manage a Team of 4 Direct Reports
Education
ā¢ Bachelor's degree in Nursing, Clinical Sciences, Population Health, Healthcare Administration, Business Administration, or related field REQUIRED
Certification/Licenses
ā¢ Registered Nurse License in Virginia OR Compact/Multi-state preferred
Experience
ā¢ 3 years of experience with HEDIS, STARS, PWP, or Clinical Improvement REQUIRED
ā¢ 3 years of supervisory or management experience REQUIRED
ā¢ Prior experience in Project Management and Performance Improvement preferred
ā¢ Strong project management and cross-functional collaboration skills REQUIRED
ā¢ Ability to interpret clinical data and translate insights into actionable strategies REQUIRED
ā¢ Experience working with vendors and managing outreach campaigns REQUIRED
ā¢ Health Plan experience is preferred
To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-98308
#Indeed
Talroo - Health Plan
Keywords: Health Plan, Healthcare, Health Insurance, MCO, Managed Care, Medicaid, Medicare, DSNP, Commercial, Group insurance, Remote, Virginia, VA, Quality, Performance, STARS, Consumer Assessment of Healthcare Providers and Systems, CAHPS, Performance Withold Program, PWP, and Healthcare Effectiveness Data and Information Set, HEDIS, North Carolina, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, Wyoming
Benefits: Caring For Your Family and Your Career
ā¢ Medical, Dental, Vision plans
ā¢ Adoption, Fertility and Surrogacy Reimbursement up to $10,000
ā¢ Paid Time Off and Sick Leave
ā¢ Paid Parental & Family Caregiver Leave
ā¢ Emergency Backup Care
ā¢ Long-Term, Short-Term Disability, and Critical Illness plans
ā¢ Life Insurance
ā¢ 401k/403B with Employer Match
ā¢ Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education
ā¢ Student Debt Pay Down - $10,000
ā¢ Reimbursement for certifications and free access to complete CEUs and professional development
ā¢ Pet Insurance
ā¢ Legal Resources Plan
ā¢ Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
For positions that are available as remote work,Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
Apply tot his job
Apply To this Job
Norfolk, VA
Work Shift
First (Days)
Overview:
ā¢ The Manager, Quality Performance and Outreach plays a critical role in driving strategic initiatives to improve STARS, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Performance Withold Program (PWP), and Healthcare Effectiveness Data and Information Set (HEDIS) performance across the health plan and enterprise.
ā¢ Reporting directly to the Director, Quality Performance and Outreach, this position leads cross-functional efforts to design, implement, and evaluate outreach and quality improvement programs that enhance member experience, close care gaps, and support regulatory compliance.
ā¢ The position focuses on all lines of business, including Commercial, Medicaid, and Medicare, collaborating with other health plan departments, providers, vendors and the enterprise.
ā¢ The position will manage a Team of 4 Direct Reports
Education
ā¢ Bachelor's degree in Nursing, Clinical Sciences, Population Health, Healthcare Administration, Business Administration, or related field REQUIRED
Certification/Licenses
ā¢ Registered Nurse License in Virginia OR Compact/Multi-state preferred
Experience
ā¢ 3 years of experience with HEDIS, STARS, PWP, or Clinical Improvement REQUIRED
ā¢ 3 years of supervisory or management experience REQUIRED
ā¢ Prior experience in Project Management and Performance Improvement preferred
ā¢ Strong project management and cross-functional collaboration skills REQUIRED
ā¢ Ability to interpret clinical data and translate insights into actionable strategies REQUIRED
ā¢ Experience working with vendors and managing outreach campaigns REQUIRED
ā¢ Health Plan experience is preferred
To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-98308
#Indeed
Talroo - Health Plan
Keywords: Health Plan, Healthcare, Health Insurance, MCO, Managed Care, Medicaid, Medicare, DSNP, Commercial, Group insurance, Remote, Virginia, VA, Quality, Performance, STARS, Consumer Assessment of Healthcare Providers and Systems, CAHPS, Performance Withold Program, PWP, and Healthcare Effectiveness Data and Information Set, HEDIS, North Carolina, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, Wyoming
Benefits: Caring For Your Family and Your Career
ā¢ Medical, Dental, Vision plans
ā¢ Adoption, Fertility and Surrogacy Reimbursement up to $10,000
ā¢ Paid Time Off and Sick Leave
ā¢ Paid Parental & Family Caregiver Leave
ā¢ Emergency Backup Care
ā¢ Long-Term, Short-Term Disability, and Critical Illness plans
ā¢ Life Insurance
ā¢ 401k/403B with Employer Match
ā¢ Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education
ā¢ Student Debt Pay Down - $10,000
ā¢ Reimbursement for certifications and free access to complete CEUs and professional development
ā¢ Pet Insurance
ā¢ Legal Resources Plan
ā¢ Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
For positions that are available as remote work,Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
Apply tot his job
Apply To this Job