Manager, Quality Performance and Outreach (STARS/ CAHPS/ PWP/ HEDIS)- Remote
10 hours ago
Norfolk
City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans is hiring for a Manager, Quality Performance and Outreach (STARS/ CAHPS/ PWP/ HEDIS)- Remote! Status: Full-time,permanent position (40 hours) Standard working hours: 8am to 5pm EST, M-F. Location: Remote opportunities available in the following states: Virginia, North Carolina, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, Wyoming Overview • The Manager, Quality Performance and Outreach plays a critical role in driving strategic initiatives to improve STARS, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Performance Withold Program (PWP), and Healthcare Effectiveness Data and Information Set (HEDIS) performance across the health plan and enterprise., • Reporting directly to the Director, Quality Performance and Outreach, this position leads cross-functional efforts to design, implement, and evaluate outreach and quality improvement programs that enhance member experience, close care gaps, and support regulatory compliance ., • The position focuses on all lines of business, including Commercial, Medicaid, and Medicare, collaborating with other health plan departments, providers, vendors and the enterprise., • The position will manage a Team of 4 Direct Reports Education • Bachelor's degree in Nursing , Clinical Sciences, Population Health, Healthcare Administration, Business Administration, or related field REQUIRED Certification/Licenses • Registered Nurse License in Virginia OR Compact/Multi-state p referred Experience • 3 years of experience with HEDIS, STARS, PWP, or Clinical Improvement REQUIRED, • 3 years of supervisory or management experience REQUIRED, • Prior experience in Project Management and Performance Improvement p referred, • Strong project management and cross-functional collaboration skills REQUIRED, • Ability to interpret clinical data and translate insights into actionable strategies REQUIRED, • Experience working with vendors and managing outreach campaigns REQUIRED Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals. We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services-all to help our members improve their health. Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth. Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve! To apply, please go to and use the following as your Keyword Search: JR-98308 Talroo - Health Plan Keywords: Health Plan, Healthcare, Health Insurance, MCO, Managed Care, Medicaid, Medicare, DSNP, Commercial, Group insurance, Remote, Virginia, VA, Quality, Performance, STARS, Consumer Assessment of Healthcare Providers and Systems, CAHPS, Performance Withold Program, PWP, and Healthcare Effectiveness Data and Information Set, HEDIS, North Carolina, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, Wyoming Benefits: Caring For Your Family and Your Career Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000, • Paid Time Off and Sick Leave, • Paid Parental & Family Caregiver Leave, • Emergency Backup Care, • Long-Term, Short-Term Disability, and Critical Illness plans, • Life Insurance, • 401k/403B with Employer Match, • Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education, • Student Debt Pay Down - $10,000 In support of our mission "to improve health every day," this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.