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Program Manager, Senior, Medi-Cal QI

    Highlights

    The Medi-Cal Quality Improvement (QI) team is responsible for developing and executing targeted quality improvement initiatives that support the Medi-Cal line of business and drive improved performance across quality rating systems, including but not limited to, Healthcare Effectiveness Data Information Set (HEDIS), Managed Care Accountability Set (MCAS), Consumer Assessment of Healthcare Providers and Systems System (CAHPS), National Committee for Quality Assurance (NCQA) Health Plan Ratings, Department of Managed Health Care (DMHC) Health Equity Quality Measure Set (HEQMS), and Medicaid Quality Rating System (QRS). You will support and partner with internal Quality Program Managers, internal cross-functional teams, clinical leadership, provider organizations, external vendors, and community-based organizations to execute improvement strategies, strengthen provider relationships, and align current and future QI programs with long-term organization goals.

    Numbers & Facts

    LocationLong Beach, CA
    IndustryInsurance
    Company Size2,000 to 2,499 employees
    Websitehttps://www.bcbs.com/about-us/careers

    Description

    Your Role

    The Medi-Cal Quality Improvement (QI) team is responsible for developing and executing targeted quality improvement initiatives that support the Medi-Cal line of business and drive improved performance across quality rating systems, including but not limited to, Healthcare Effectiveness Data Information Set (HEDIS), Managed Care Accountability Set (MCAS), Consumer Assessment of Healthcare Providers and Systems System (CAHPS), National Committee for Quality Assurance (NCQA) Health Plan Ratings, Department of Managed Health Care (DMHC) Health Equity Quality Measure Set (HEQMS), and Medicaid Quality Rating System (QRS). The Program Manager, Senior, Quality Improvement, will report to the Medi-Cal Quality Improvement Team's Senior Manager. In this role, you will design, develop, and manage tertiary provider groups' quality interventions, toolkits, clinic days, and analytic insights that support measurable improvement in quality performance. You will support and partner with internal Quality Program Managers, internal cross-functional teams, clinical leadership, provider organizations, external vendors, and community-based organizations to execute improvement strategies, strengthen provider relationships, and align current and future QI programs with long-term organization goals.

    Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

    This is a hybrid field-based role serving the Los Angeles area. The position requires a minimum of five to eight days per month working from the Long Beach or Woodland Hills offices and/or visiting local clinics. Clinic visits typically occur 1-2 days per week. Some evening and Saturday hours may also be required.

    About Company

    At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry. We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

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