Quality Improvement Manager

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. Manager, Quality Improvement, Member Experience is responsible for leading quality improvement activities related to the Member Experience to achieve Medicare STAR outcomes. This may include, but is not limited to project and program management, process improvement, campaign coordination, and outcomes measurement. Measures related to Member Experience include CAHPS, Admin, HEDIS, and HOS. • Possess a deep understanding of the Medicare STAR program and lead the implementation and execution of strategy to improve outcomes in designated measures • Lead and coordinate collaborative projects with internal stakeholders that impact the Member Experience including but not limited to Member Services, Concierge, Member Engagement, Member Retention, Appeals & Grievances, Sales, Product, Network Management, Membership & Eligibility, Claims, Utilization Management, Case Management, Clinical Programs, Data Science, Data & Technology Services • Participate in and make the most of Joint Work Groups, Joint Operation Committee meetings, and other forums for improving the performance of our Provider Network • Facilitate high-impact stakeholder meetings through strategic agenda planning and preparation, and thorough management of action items; lead interdisciplinary workgroups to analyze, plan, and implement programs, processes, and workflows • Develop project work plans by defining tasks, setting deadlines, assigning responsibilities, and procuring resources • Efficiently respond to requests for information and analysis, and thoughtfully apply the findings towards process improvement initiatives; track and report on outcomes and KPIs • Rigorously prioritize process improvement efforts in line with Medicare STAR outcomes • Utilize digital strategies to optimize results for member engagement and member experience • Understand and improve systems that impact Member Experience including but not limited to AVA CRM, AVA Care on Demand, AVA A&G, EMR • Drive better reporting and dashboards that level-up all related teams, and align their metrics and decision-making to Medicare STAR outcomes • Maintain positive relationships within Alignment Healthcare business units and operational departments and other project stakeholders by coordinating information exchange, keeping stakeholders informed of progress and risks, and maintaining project documentation • Oversees assigned staff. Responsibilities include: recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring and appraising job results; and coaching, counseling, and disciplining employees • Exercise creativity and flexibility by determining the appropriate combination of knowledge, skills, tools, and techniques for assigned projects. • Ensure patient privacy is protected by adhering to HIPAA standards, company policies and procedures, and other federal, state, and local requirements. Pay Range: $85,696.00 - $128,543.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation. • DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected]. Apply tot his job