... ones, training, and team building Please note that onsite requirements may change in the future ... Subject matter expertise with NCQA HEDIS and CMS Core performance measure calculation and data ...
... ones, training, and team building Please note that onsite requirements may change in the future ... Subject matter expertise with NCQA HEDIS and CMS Core performance measure calculation and data ...
Director of Quality Improvement
San Bernardino, CA · On-site
$130K - $145K/yr
... plan contractual requirements. The Director works collaboratively with executive leadership ... Education/Training Minimum: Bachelor's degree in Healthcare Administration, Nursing, Public Health ...
Director of Quality Improvement
San Bernardino, CA · On-site
$130K - $145K/yr
... plan contractual requirements. The Director works collaboratively with executive leadership ... Education/Training Minimum: Bachelor's degree in Healthcare Administration, Nursing, Public Health ...
Director of Quality Improvement
$130K - $145K/yr
... plan contractual requirements. The Director works collaboratively with executive leadership ... Education/Training Minimum: Bachelor's degree in Healthcare Administration, Nursing, Public Health ...
Director of Quality Improvement
$130K - $145K/yr
... plan contractual requirements. The Director works collaboratively with executive leadership ... Education/Training Minimum: Bachelor's degree in Healthcare Administration, Nursing, Public Health ...
Director of Quality Improvement
San Bernardino, CA · On-site
$130K - $145K/yr
... plan contractual requirements. The Director works collaboratively with executive leadership ... Education/Training Minimum: Bachelor's degree in Healthcare Administration, Nursing, Public Health ...
Director of Quality Improvement
San Bernardino, CA · On-site
$130K - $145K/yr
... plan contractual requirements. The Director works collaboratively with executive leadership ... Education/Training Minimum: Bachelor's degree in Healthcare Administration, Nursing, Public Health ...
Sup, Clinical Quality Mgmt
Phoenix, AZ · On-site
Medical
Dental
Vision
Life
Retirement
PTO
... contractual requirements; and ensuring compliance with URAC standards. The Supervisor oversees ... Supports recruitment efforts by interviewing, selecting, and training new staff. • Ensures that ...
Sup, Clinical Quality Mgmt
Phoenix, AZ · On-site
Medical
Dental
Vision
Life
Retirement
PTO
... contractual requirements; and ensuring compliance with URAC standards. The Supervisor oversees ... Supports recruitment efforts by interviewing, selecting, and training new staff. • Ensures that ...
Senior Data Analyst
Washington, DC · Remote
$135K - $150K/yr
Medical
Dental
Vision
Retirement
... contractual modeling. This role reports directly to the Chief Information Officer. * Supports the ... Formal informatics training preferred (SQL, SAS) * 5+ years of experience with healthcare ...
Quick apply
Senior Data Analyst
Washington, DC · Remote
$135K - $150K/yr
Medical
Dental
Vision
Retirement
... contractual modeling. This role reports directly to the Chief Information Officer. * Supports the ... Formal informatics training preferred (SQL, SAS) * 5+ years of experience with healthcare ...
Senior Data Analyst
Washington, DC · Remote
$135K - $150K/yr
Medical
Dental
Vision
Retirement
... contractual modeling. This role reports directly to the Chief Information Officer. * Supports the ... Formal informatics training preferred (SQL, SAS) * 5+ years of experience with healthcare ...
Quick apply
Senior Data Analyst
Washington, DC · Remote
$135K - $150K/yr
Medical
Dental
Vision
Retirement
... contractual modeling. This role reports directly to the Chief Information Officer. * Supports the ... Formal informatics training preferred (SQL, SAS) * 5+ years of experience with healthcare ...
Grievance & Appeals Resolution Specialist
Huntington Beach, CA · Hybrid
$26 - $32/hr
... contractual requirements. This role independently manages assigned cases within established ... and training materials. · Support HEDIS-related activities as assigned, including data entry ...
Grievance & Appeals Resolution Specialist
Huntington Beach, CA · Hybrid
$26 - $32/hr
... contractual requirements. This role independently manages assigned cases within established ... and training materials. · Support HEDIS-related activities as assigned, including data entry ...
Medical Director Complex Care New Orleans
New Orleans, LA · On-site
$230 - $320/hr
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Medical Director Complex Care New Orleans
New Orleans, LA · On-site
$230 - $320/hr
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Infectious Disease Physician
New Orleans, LA · On-site
$300K/yr
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Infectious Disease Physician
New Orleans, LA · On-site
$300K/yr
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Medical Director
New Orleans, LA · On-site
$180 - $300/hr
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Medical Director
New Orleans, LA · On-site
$180 - $300/hr
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Quality Management Specialist
Medical
Dental
Vision
Life
Retirement
PTO
Collect, track, and trend data to support staff training and improvement. * Initiate and support ... Develop and perform scheduled audits to ensure grant and contractual compliance DUTIES PERFORMED:
Quality Management Specialist
Medical
Dental
Vision
Life
Retirement
PTO
Collect, track, and trend data to support staff training and improvement. * Initiate and support ... Develop and perform scheduled audits to ensure grant and contractual compliance DUTIES PERFORMED:
Family Practice - Without OB Physician
New Orleans, LA · On-site
$300K/yr
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Family Practice - Without OB Physician
New Orleans, LA · On-site
$300K/yr
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Medical Director - 2984
New Orleans, LA · On-site
$250 - $320/hr
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Medical Director - 2984
New Orleans, LA · On-site
$250 - $320/hr
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Grievance & Appeals Resolution Specialist
Huntington Beach, CA · On-site
$26 - $32/hr
... contractual requirements. This role independently manages assigned cases within established ... training materials. • Support HEDIS-related activities as assigned, including data entry ...
Grievance & Appeals Resolution Specialist
Huntington Beach, CA · On-site
$26 - $32/hr
... contractual requirements. This role independently manages assigned cases within established ... training materials. • Support HEDIS-related activities as assigned, including data entry ...
Internal Medicine Physician
New Orleans, LA · On-site
$300K/yr
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Internal Medicine Physician
New Orleans, LA · On-site
$300K/yr
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Medical Director - 2984
New Orleans, LA · On-site
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Medical Director - 2984
New Orleans, LA · On-site
Manage the team to track and meet contractual quality metric goals. * Use technology and the ... Preferred Qualifications Infectious Disease training (Board Certification) or AAHIVM certification ...
Contractual Hedis Training information
See salary details
$20.19 - $22.71
2% of jobs
$22.71 - $25.22
3% of jobs
$25.22 - $27.73
3% of jobs
$29.15 is the 25th percentile. Wages below this are outliers.
$27.73 - $30.24
29% of jobs
$30.24 - $32.76
6% of jobs
The median wage is $33.82 / hr.
$32.76 - $35.27
14% of jobs
$35.27 - $37.78
13% of jobs
$38.31 is the 75th percentile. Wages above this are outliers.
$37.78 - $40.30
19% of jobs
$40.30 - $42.81
5% of jobs
$42.81 - $45.32
3% of jobs
$45.32 - $47.84
1% of jobs
$20
$34
$47
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Manager, Performance/Quality Improvements - HYBRID
Phoenix, AZ • On-site
Full-time
Re-posted 14 days ago
Blue Cross Blue Shield Of Arizona rating
5.9
Based on 13 frontline employees who took The Breakroom Quiz
290th of 308 rated insurance
Job description
At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:
- Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
- Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
- Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
- Onsite: daily onsite requirement based on the essential functions of the job
- Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building
Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.
This position is hybrid within the state of AZ only. This hybrid work opportunity requires residency, and work to be performed, within the State of Arizona.
PURPOSE OF THE JOB
The position is responsible for managing Quality Improvement activities as well as staff conducting quality improvement work as outlined in AHCCCS contract and policy for the Medicaid Segment. This position and staff reporting to this position shall reside in Arizona within the Geographical Service Area for contract compliance, have knowledge of both physical and behavioral health service delivery, monitor, review and evaluate performance measure data and technical specifications. The employee holding this position shall not hold any other position within the organization.
QUALIFICATIONS
REQUIRED QUALIFICATIONS
Required Work Experience
- 5 years experience in the health care payer or provider space
Required Education
- Bachelor's Degree
Required Licenses
- N/A
Required Certifications
- CPHQ through the National Association for Health Care Quality (NAHQ) or is a CHCQM through the American Board of Quality Assurance and Utilization Review Physicians
PREFERRED QUALIFICATIONS
Preferred Work Experience
- 10 years healthcare experience, within the Arizona Medicaid system preferred
- Experience leading system-wide interdisciplinary improvement projects
Preferred Education
- Master's degree in business, healthcare administration or healthcare related field
Preferred Licenses
- N/A
Preferred Certifications
- N/A
ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES
- Responsible for driving performance improvement for National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) and other quality metrics
- Develops and implements system-wide performance improvement projects
- Development and monitoring of Corrective Action Plans for effectiveness in achieving performance targets and reporting on effectiveness of recommended actions
- Collaborates with internal departments including Quality Management, Performance Improvement and Quality Analytics on NCQA HEDIS performance measurement to ensure data integrity
- Supervises employees performing performance improvement and monitoring functions
- Reports quality improvement and performance outcomes to leadership, regulatory bodies and stakeholders
- Analyzes data and communicates results and recommendations with internal and external staff and provider agencies
- Monitors and tracks provider performance and data from multiple sources to identify and respond to trends and or emerging issues and to ensure compliance with minimum standards
- Utilizes data to develop intervention strategies to improve outcomes and reports quality improvement and performance outcomes as requested to ensure ongoing compliance with contractual requirements
- Conducts research, reviews, analyzes and compiles data, develops recommendations and reports
- Some travel is required to attend meetings with AHCCCS, provider agencies and other meetings as assigned
- The position has an onsite expectation of 2 days per week and requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
- Perform all other duties as assigned
COMPETENCIES
REQUIRED COMPETENCIES
Required Job Skills
- Subject matter expertise with NCQA HEDIS and CMS Core performance measure calculation and data collection methodologies
- Experience with Medicaid managed care organizations
- Proven record of accomplishment working with executives across a multi layered organizational platform
- Proficiency in developing and presenting analytic reports including written and verbal communication, data collection, sampling, analysis and presentation
- Excellent analytical and problem solving skills
- Ability to establish trust with all levels of stakeholder groups
- Exceptional interpersonal, influence, collaboration and listening skills
- Strong written communication skills including ability to use Microsoft applications such as MS Project, Word, Excel and PowerPoint
- Ability to maintain confidentiality, privacy and security of protected information
- Required Professional Competencies
- Strategic and consultative approach to program management
- Strong analytical skills with ability to quickly identify issues, root causes and solutions
- Ability to make decisions confidently and work independently
- Flexible and willing to adjust to changing priorities
- Required Leadership Experience and Competencies
- Confidence working with all levels of the organization and external partners
- Collaborative and motivational leadership style across multiple teams
- Ability to handle sensitive and confidential situations with professionalism and diplomacy
PREFERRED COMPETENCIES
Preferred Job Skills
- Advanced PC proficiency with word processing, spreadsheets and presentation software
- Experience with Daptiv preferred
Preferred Professional Competencies
- N/A
Preferred Leadership Experience and Competencies
- N/A
Our Commitment
AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.
Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.
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About Blue Cross Blue Shield of Arizona
Sourced by ZipRecruiter
Industry
Insurance services
Company size
1,001 - 5,000 Employees
Headquarters location
Phoenix, AZ, US
Year founded
1939