Quality Program Manager - Remote

Overview

Oversee and actively participate in quality improvement projects that support the organization’s mission of effectively managing members and improving health outcomes. Serve as a liaison between Quality Management and internal/external partners for quality initiatives. Act as a subject matter expert in quality improvement and reporting.

In Short

• Plan, implement, and oversee quality improvement projects across various product lines.
• Support execution of data-driven strategic plans.
• Lead collaboration on quality metrics.
• Manage relationships with quality vendors and monitor performance.
• Oversee ongoing quality programs and initiatives.
• Provide expertise on quality metrics to stakeholders.
• Ensure compliance with regulatory requirements.
• Collaborate with data teams for analysis and reporting.
• Develop and manage performance improvement projects.
• Create methodologies for evaluating quality outcomes.

Requirements

• Bachelor’s Degree required; Master’s Degree strongly preferred.
• Knowledge of New York Market.
• Project Management or Vendor Management certification preferred.
• 5–8 years of relevant professional experience required.
• 3–5 years of quality or program management experience in managed care.
• Experience in developing quality metrics and analytics.
• Strong understanding of Service Level Agreements (SLAs).
• Ability to manage multiple tasks/projects with competing priorities.
• Knowledge of HEDIS/QARR, CAHPS, CMS Star Ratings.
• Proficient in Microsoft Office; knowledge of Access preferred.

Benefits

• Equal opportunity employer.
• Prohibits discrimination/harassment.