Sr. Manager - Quality Care Improvement

Astrana is seeking a Manager - Quality Improvement to be responsible for leading quality initiatives and teams within the Quality Department. This role has direct oversight over regional operations for quality related activities including supervision of staff, design/deployment of activities, and managing external partner relationships such as health plans and providers. The manager oversees assigned programs, projects, and lines of business, ensuring effective coordination and execution of HEDIS and Medicare Star Ratings initiatives. This role serves as a key liaison between Astrana Health, health plans, IPA partners, and providers to drive quality performance and compliance. Our Values: Put Patients First Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence Be Innovative Work As One Team What You'll Do The Manager - Quality Improvement is responsible for leading quality initiatives and teams within the Quality Department. This role has direct oversight over regional operations for quality related activities including supervision of staff, design/deployment of activities, and managing external partner relationships such as health plans and providers. The manager oversees assigned programs, projects, and lines of business, ensuring effective coordination and execution of HEDIS and Medicare Star Ratings initiatives. This role serves as a key liaison between Astrana Health, health plans, IPA partners, and providers to drive quality performance and compliance. ESSENTIAL DUTIES AND Leadership and oversight over day-to-day operations for designated areas Oversee health plan metrics and ratings including identifying, addressing gaps in performance Collaborate with peers within assigned regions and across the organization to deploy effective programs for quality gap closures Lead health plan, IPA and provider meetings to review KPIs, share best practices and design process improvement activities to improve outcomes Manage quality data workflows between Astrana and health plans to ensure complete and accurate submission of relevant data Support audits requested by payers or other partners to meet compliance requirements • Able to prioritize work to reach overall team goals Be detail oriented and show strong organizational skills. Drive outcomes for critical measures assigned to other departments through cross functional teamwork and support Able to analyze key trends and succinctly communicate findings to leadership, providers, health plans Able to identify barriers or risks early and escalate to leadership for support and intervention Manage a team remotely to execute on provider engagement and execution of key initiatives Hire, retain, mentor, and manage performance for direct reports through a culture of accountability, collaboration, and continuous improvement. Ensure all work completed meets internal compliance requirements as well as health plan and NCQA compliance. Be responsible for assigned health plans including managing ongoing relationships with key individuals, attending meetings, and providing updated presentations among other required tasks. Participate in staff hiring efforts and evaluation of performance during introductory period and annually Maintain a professional demeanor at all times with both internal and external stakeholders, including being timely in responses, delivering exceptional customer service, and maintaining clear communication. Performance manage direct reports as appropriate and with guidance from HR and department leaders Attend regional meetings in person or remotely depending on business needs Able to present to large groups of providers or team members including managing Q/A Be a subject matter expert in NCQA guidelines for quality measures and able to direct providers to address gap closures within these parameters. Performs other duties, projects and actions assigned in a professional manner, utilizing time and resources efficiently. Qualifications Minimum of BA/BS degree or equivalent work experience Master’s Degree highly preferred 5+ years of quality/HEDIS work experience; 2+ years of supervisory/management experience required Strong knowledge of value-based programs and managed care operations Subject matter expert in NCQA technical specifications or demonstrated ability to access this information Excellent oral and writing skills are characterized by the ability to communicate effectively with audiences at all levels Excellent analytical critical reasoning and interpersonal communication skills Must be ethical and possess the ability to remain impartial and objective At least intermediate skills in MS Excel and PowerPoint Good organization, critical thinking, and problem-solving skills Environmental Job Requirements and Working Conditions This is a full-time, remote position. Candidates must be able to travel up to 25% of the time to assigned regions and able to travel to corporate offices as needed. The office is located at 1600 Corporate Center Drive in Monterey Park, CA. The national target pay range for this position is $105,000 - $130,000 per year. Actual compensation will be based on experience, geographic location (current or future), and other job-related factors. Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at [email protected] to request an accommodation.