L.A. Care Health Plan Manager, Quality Improvement Initiatives in Los Angeles, California
DUTIES The Manager, Quality Improvement Initiatives is an experienced healthcare professional responsible for overseeing activities of LA Care's Quality Improvement Programs. The position reports directly to the Clinical Director of Quality Improvement. The Manager manages the performance of health plan quality improvement activities, provider quality reviews, establishes and monitors quality improvement goals, organizes outcomes research, and assures that L.A. Care meets CMS, DMHC, NCQA and other regulatory agencies' standards for quality. .
The Manager interfaces with colleagues at other local initiative health plans statewide, with our sub-contracted health plan partners, provider groups, regulatory agencies and network providers to represent L.A. Care and lead statewide/local quality improvement projects. This position supervises the Quality Improvement Department, Quality Improvement Work Groups, and any special projects as assigned by the Medical Director or Senior Director.
Develops and Implements Interventions to improve performance on key Medi-Cal Measures. Works closely with Medicare Operations on Quality Improvement efforts for CMC. QIP, CCIP, Annual QI Program and Evaluation. Oversees Incentive team which runs portfolio of Provider Pay for Performance programs and Member Incentives.
QUALIFICATIONS AND REQUIREMENTS
EDUCATION Required Associate's Degree
Preferred Master's Degree in Health Care Field
LICENSES/CERTIFICATIONS Preferred Registered Nurse CPUR, CCM, CPHQ
EXPERIENCE Required With Associate's Degree: Minimum 8 years of operational and/or clinical management experience within health care systems, primarily in a managed care environment, preferably with relevant Quality Improvement/Quality Management experience; with 2 years of progressive management experience.
With Bachelor's Degree: 5-7years of operational and/or clinical management experience within health care systems, primarily in a managed care environment, preferably with relevant Quality Improvement/Quality Management experience; with 2 years of progressive management experience.
Formal certification/licensure in one or more areas of professional expertise. Knowledge of regulatory and accreditation requirements. Technical knowledge of quality improvement, HEDIS and NCQA standards. Proficiency with MS Office and other computer programs relevant to the performance of the position. Demonstrated ability to manage, organize and analyze data. Excellent interpersonal, written, verbal and presentation skills. Demonstrated ability to lead a team to successful and timely achievement of organizational objectives. Good organizational skills.
Job Title: Manager, Quality Improvement Initiatives
Job Category: Management / Executive
Department: Quality Improvement
Location: Headquarters, Downtown Los Angeles
Position Type: Full-time
Position Control Number: A114
Pay Grade: M