New

Manager, Quality Improvement- Remote in VA!

Sentara
paid time off, tuition reimbursement, 401(k), 403(b)
United States, Virginia, Glen Allen
Jan 30, 2025
City/State Glen Allen, VA Overview Work Shift First (Days) (United States of America) Sentara Healthcare is hiring a Manager, Quality Improvement in Virginia! Position Status: Full-time (40 hours), Day Shift Standard Working Hours: 8:00AM to 5:00PM (ET). Position Location: This is a remote position in VA. Will need to go to the office as needed. Job responsibilities: The Manager, Quality Improvement at Sentara Health Plans is responsible for the oversight and leadership of all quality, regulatory, accreditation and population health outcomes for multiple product lines or multiple health plans. Oversees a team of Managers leading teams of Quality and Population Health resources. This includes, but is not limited to efforts associated with the National Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data and Information Set (HEDIS), the Department of Medical Assistance Services (DMAS), the Centers for Medicare and Medicaid Services (CMS) and other required entities associated with or required by the state and/or federal government. Establishes quality performance initiatives impacting outcomes for the populations and recommends quality strategies. Works closely and collaboratively across all Sentara Health Plans and the various departments, at each health plan, to achieve the goals and objectives of the Quality Program. Required qualifications: 1 year Project Management experience, 1 year Quality Improvement experience and 3 years Regulatory/Compliance experience REQUIRED Preferred qualifications: Advanced Degree: MBA, MPA, MHA, MSN, NP or other related degree preferred Six Sigma Green or Black Belt: Three or more years of Six Sigma application experience preferred Certified Professional in Health care Quality (CPHQ): CPHQ Certification preferred Nursing degree preferred but not required 1 year Health Insurance Plans experience, 3 years Medicaid, Medicare, Process Improvement experience preferred Benefits: Sentara offers an attractive array of full-time benefits to include Medical, Dental, Vision, Paid Time Off, Sick, Tuition Reimbursement, a 401k/403B , 401a, Performance Plus Bonus, Career Advancement Opportunities, Work Perks and more. Sentara Health Plans is the health insurance division of Sentara Healthcare. Sentara Health Plans provides health insurance coverage through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees. With more than 30 years' experience in the insurance business and 20 years' experience serving Medicaid populations, 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 www.sentaracareers.com and use the following as your Keyword Search: JR-71273 Monster Talroo - Health Plan Managed Care, MCO, Health Plan, Healthcare, Project Management, Quality Improvement, Regulatory, Compliance, RN, MBA, MPA, MHA, MSN, NP, Six Sigma Green Belt, Black Belt, Certified Professional in Health care Quality, CPHQ, Medicaid, Medicare, Process Improvement, Remote, Virginia Job Summary The Manager, Quality Improvement at Sentara Health Plans is responsible for the oversight and leadership of all quality, regulatory, accreditation and population health outcomes for multiple product lines or multiple health plans. Oversees a team of Managers leading teams of Quality and Population Health resources. This includes, but is not limited to efforts associated with the National Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data and Information Set (HEDIS), the Department of Medical Assistance Services (DMAS), the Centers for Medicare and Medicaid Services (CMS) and other required entities associated with or required by the state and/or federal government. Establishes quality performance initiatives impacting outcomes for the populations and recommends quality strategies. Works closely and collaboratively across all Sentara Health Plans and the various departments, at each health plan, to achieve the goals and objectives of the Quality Program. Nursing: Three or more years of clinical nursing experience Advanced Degree: MBA, MPA, MHA, MSN, NP or other related degree preferred Six Sigma Green or Black Belt: Three or more years of Six Sigma application experience preferred Certified Professional in Health care Quality (CPHQ): CPHQ Certification preferred Qualifications: BLD - Bachelor's Level Degree (Required) Registered Nurse (RN) Single State - Nursing License - North Carolina, Registered Nurse (RN) Single State - Nursing License - Virginia Department of Health Professionals (VADHP) Health Insurance Plans, Medicaid, Medicare, Process Improvement, Project Management, Quality Improvement, Regulatory/Compliance Skills Active Learning, Active Learning, Active Listening, Communication, Complex Problem Solving, Coordination, Critical Thinking, Judgment and Decision Making, Leadership, Learning Strategies, Mathematics, Mgmt of Financial Resources, Mgmt of Material Resources, Mgmt of Staff Resources, Microsoft Excel, Microsoft Word, Monitoring, Persuasion, Project Management, Quality Control Analysis, Reading Comprehension, Science, Service Orientation, Social Perceptiveness, Speaking {+ 5 more} Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application. In support of our mission "to improve health every day," this is a tobacco-free environment.