Manager, Quality Performance and Outreach (CAHPS HOS Medicare)

Status: Full-timepermanent position (40 hours)

Standard working hours: 8am to 5pm EST M-F.

Location: Remote opportunities available in the following states: Virginia 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

Overview

• 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.

• The position will focus in Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Health Outcomes Survey (HOS) for Medicare and member rewards and data analysis for all lines of business

• 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.

• The position focuses on all lines of business including Commercial Medicaid and Medicare collaborating with other health plan departments providers vendors and the enterprise.

• The position will manage a Team of 3 to 6 Direct Reports

Education

• Bachelors degree in Nursing Clinical Sciences Population Health Healthcare Administration Business Administration or related field REQUIRED

Certification/Licenses

• Registered Nurse License in Virginia OR Compact/Multi-state preferred

Experience

• 3 years of experience with HEDIS STARS PWP or Clinical Improvement REQUIRED

• 3 years of supervisory or management experience REQUIRED

• Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Health Outcomes Survey (HOS) for Medicare highly preferred

• Prior experience in Project Management and Performance Improvement REQUIRED

• Strong project management and cross-functional collaboration skills REQUIRED

• Ability to interpret clinical data and translate insights into actionable strategies REQUIRED

• Experience working with vendors and managing outreach campaigns REQUIRED

• Health Plan experience is preferred

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans as well as Individual & Family Health Plans Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.

Our quality provider network features a robust provider network including specialists primary care physicians and hospitals.

We offer programs to support members with chronic illnesses customized wellness programs and integrated clinical and behavioral health servicesall to help our members improve their health.

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

We provide market-competitive compensation packages inclusive of base pay incentives and benefits. The base pay rate for Full Time employment is: $38.22/hour min - $63.70/hour max. Additional compensation may be available for this role such as shift differentials standby/on-call overtime premiums extra shift incentives or bonus opportunities.

Be a part of an excellent healthcare organization that cares about our People Quality Patient Safety Service and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

To apply please go to and use the following as your Keyword Search: JR-103770

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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 Health Outcomes Survey (HOS)