Program Manager - Quality Improvement

Position Summary
The Program Manager, Quality Improvement works to improve patient health outcomes and meet organization wide quality improvement goals. The position is responsible for process improvement, implementing identified quality improvement initiatives and data analytics to support quality improvement initiatives. The position collaborates with IS, Operations, Medical Services, and other departments to build alignment and support improvement of quality metrics.

Core Job Responsibilities

Maintains subject matter expertise in CMS/UDS, HEDIS/NCQA and STARS quality measures to support organizational compliance and performance excellence.
Applies quality improvement methodologies and tools to develop, recommend, and implement initiatives that enhance healthcare quality and patient outcomes.
Works closely with the reporting team and other key committees to develop data-driven reports that monitor improvement initiatives aligned with organizational and departmental priorities.
Designs, documents, and optimizes workflows and process maps that contribute to quality goals and improve operational effectiveness.
Partners with providers and operation teams to communicate critical quality needs, fostering enhancements in patient care, provider satisfaction, and patient outcomes.
Collaborates with Learning & Development, Information Systems, and Medical Services to develop and implement training programs that support improved documentation and quality enhancement efforts.
Leads project planning efforts, including stakeholder identification, facilitating workgroup meetings, tracking project milestones, and ensuring timely completion of quality initiatives.
Supports continuous improvement efforts by identifying performance gaps, recommending best practices, and assisting teams in executing sustainable solutions.
Performs additional duties as assigned to support the organization’s mission and quality improvement objectives.

Requirements/Preferences

Bachelor’s degree in Healthcare Administration, Public Health, Nursing, or a related field required. Master’s degree preferred.
Minimum of three (3) years of experience in quality improvement, including HEDIS, CMS measures, benchmarking, analytics, and/or healthcare data reporting required.
Minimum of two (2) years of experience in a primary care or ambulatory care setting required.
Strong project management experience with demonstrated ability to manage multiple initiatives and drive measurable results required.
Strong analytical, organizational, and problem-solving skills with experience interpreting healthcare quality data required.
Working knowledge of electronic health record (EHR) systems required.
Bachelor’s degree in Nursing preferred.
Experience with EPIC EHR systems preferred.