CareFirst Careers

Manager, Quality - Measurement

Resp & Qualifications

PURPOSE
The Quality Manager leads a team of associates responsible for defining, measuring, analyzing, and evaluating population health, while prioritizing, developing, and operationalizing innovative initiatives to improve the quality of care and experience, resulting in industry-leading outcomes at a population level.

ESSENTIAL FUNCTIONS

Manages, develops, and leads a team in a matrixed organization environment

Monitors, measures, and ensures compliance with accreditation requirements, quality performance methodologies, and applicable state, local, and federal regulations

Formulates and implements the enterprise strategy for population health, quality, and member experience improvement

Drives the progress and completion of innovative initiatives and evaluates their effectiveness


QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education Level: Bachelor's Degree

Education Details: population health, public health, healthcare administration, business administration, health policy, economics, statistics, mathematics, data science, or a related field;

Experience: 5 years experience in a healthcare, public health, health insurance, quality/process improvement or data management business environment; inclusive of 3 years data analytics experience working with large data sets to answer clinical, operational, or business questions; prior experience with HEDIS, CAHPS, NCQA, quality measurement, population health analytics, and value-based reimbursement models highly valued
1 year supervisory experience or demonstrated progressive leadership experience

In Lieu of Education: In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Preferred Qualifications
Training or certification in Quality or Process Improvement Methods

Knowledge, Skills and Abilities (KSAs) Proficiency
Ability to perform qualitative and quantitative data analyses and create innovative strategies and work with colleagues to address findings Advanced
Ability to learn the technical aspects of collection and reporting of both administrative and clinical aspects of quality measures. Advanced
Ability to conduct advanced analytics using SQL, Python, R, or similar; fluent in Excel. Expertise with healthcare claims, survey, clinical, and health data. Proficient
Strong computer skills to include Microsoft Office - Excel, Word, Power Point, Outlook Advanced
Ability to mentor and coach associates to accomplish goals, provide objective evaluation of associate performance, and implement strategies to improve individual and team-based performance as needed.
Proficient
 

Department

Department:  Accreditation & Medical Programs

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

Closing Date

Please apply before: 6/18/21

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

Not finding the right job?
Stay informed about future openings by joining one of our Talent Networks!

Learn more about Medical Management