Program Manager, HEDIS & Quality Performance Reporting and Analytics

Transform Healthcare Quality with IHP: Join Our Team as a Program Manager, HEDIS & Quality Performance Reporting and Analytics

At IHP, we're committed to revolutionizing healthcare through innovative solutions and a passion for quality improvement. As a leader in the healthcare industry, we're seeking a highly skilled and experienced Program Manager to oversee our HEDIS & Quality Performance Reporting and Analytics initiatives. If you're a driven professional with a background in healthcare quality and analytics, we invite you to join our team and make a meaningful impact on the lives of our patients and communities.

About the Role

As our Program Manager, HEDIS & Quality Performance Reporting and Analytics, you will be responsible for managing all aspects of HEDIS data management, including data collection, submission, quality assurance, governance, reporting, and analysis. You'll serve as our subject matter expert on network quality measurement, working closely with health centers, payers, and other stakeholders to ensure the integrity of our data and drive quality improvement initiatives.

Key Responsibilities

• Manage the HEDIS data submission process, coordinating efforts with multiple network stakeholders and data sources, including our population health analytics platform.
• Participate in primary source verification audits from health plans, ensuring compliance with regulatory requirements and industry standards.
• Educate providers and their staff on quality measure specifications, promoting accurate documentation protocols and care gap closure.
• Train staff on optimizing network technology platforms, such as EHRs and population health data aggregation platforms, to improve quality measure rates.
• Identify and recommend clinical documentation improvement opportunities in health center electronic health record systems, enhancing data connector integrity and clinical measure performance.
• Train providers and staff on health plan P4P incentive programs, tracking progress and making recommendations for success.
• Collect medical records and reports from health centers based on open member care gaps, working directly with health center quality teams and health plan staff to monitor gap closures and improvement activities.
• Coordinate quality initiative projects for various stakeholders, performing follow-up and outcome determination.
• Submit actionable work plans to health plans and track progress, driving continuous quality improvement.
• Perform additional data management tasks as directed, supporting the success of our quality programs.

Essential Qualifications

To excel in this role, you should possess:

• A bachelor's degree in health science, quantitative social science, public health, health services research, or business, or equivalent experience.
• At least 3 years of experience in health plan quality program performance analysis at a health plan or health center.
• Experience with various EHR platforms and clinical data documentation workflows.
• Working knowledge of HEDIS and STARs technical specifications.
• A valid California driver's license and willingness to travel to provider offices throughout San Diego and the Inland Empire.

Preferred Skills and Competencies

We're looking for a professional with:

• Effective verbal and written communication skills, with the ability to articulate complex data insights to diverse stakeholders.
• Excellent interpersonal skills, fostering strong relationships with health centers, payers, and other stakeholders.
• The ability to multitask in a fast-paced environment, prioritizing tasks and managing multiple projects simultaneously.
• Innovative critical thinking, driving creative solutions to complex quality improvement challenges.
• The ability to work independently and productively in a remote setting, with minimal supervision.
• Intermediate to advanced skills with Microsoft Office Products, particularly Word and Excel.
• Experience with population health data aggregation platforms, a plus.

Career Growth and Learning Opportunities

At IHP, we're committed to the growth and development of our team members. As a Program Manager, HEDIS & Quality Performance Reporting and Analytics, you'll have opportunities to:

• Develop your skills in healthcare quality and analytics, staying up-to-date on industry trends and best practices.
• Collaborate with cross-functional teams, expanding your knowledge of healthcare operations and quality improvement initiatives.
• Take on additional responsibilities, driving your career advancement and contributing to the success of our organization.

Work Environment and Company Culture

We're a remote-friendly organization, offering a flexible work environment that supports work-life balance. Our company culture is built on a foundation of:

• Innovation: We're committed to staying at the forefront of healthcare quality and analytics, driving innovation and excellence.
• Collaboration: We foster a culture of teamwork and collaboration, working together to achieve our goals.
• Diversity, Equity, and Inclusion: We're dedicated to creating an inclusive environment, valuing diverse perspectives and experiences.

Compensation and Benefits

We offer a competitive compensation package, including:

• A salary range of $95,000 - $120,000 per year, depending on experience.
• A comprehensive benefits package, including health, dental, and vision insurance, 403(b) retirement plan, and paid time off.
• Additional perks, such as flexible scheduling, employee assistance programs, and employee discounts.

Join Our Team

If you're a motivated professional with a passion for healthcare quality and analytics, we invite you to join our team as a Program Manager, HEDIS & Quality Performance Reporting and Analytics. To apply, please submit your resume and a cover letter outlining your experience and qualifications. We can't wait to hear from you!

IHP is an equal opportunity employer, committed to diversity, equity, and inclusion. We welcome applications from qualified candidates of all backgrounds.