Why should you consider a career with Colorado Access?We are a Colorado-based company, working to improve the health of our state. We care for individuals, families, and children who receive health care under Child Health Plan Plus (CHP+) and Health First Colorado (Colorado's Medicaid Program). Our focus is driving improvements in quality, member experience, outcomes, and cost. We are a mission-driven organization whose foundation is built by our vision, supported by our values and pillared by diversity, equity and inclusion. * Find work/life balance: We offer PTO, floating holidays, nine company paid holidays, a hybrid work environment, an Employee Assistance Program and a 401K.
Be a part of something bigger and make an impact: We serve the underserved and most vulnerable populations in our community through access to quality and affordable health care. No matter what you do for Colorado Access, you are impacting our community and making a difference.
Sharpen your skills, learn, and grow: We support your continued development through tuition reimbursement, leadership training, promotion opportunities, performance evaluations, employee recognition, and a language pay stipend.
What you will do:We are looking for a SENIOR HEDIS QUALITY PROGRAM MANAGER who can help shape our vision and support our mission. Here is what the position will look like.
Leads the administration of HEDIS and CAHPS for the organization, including planning, data collection, vendor management, data integration, reporting, analysis, and submission.
Coordinates annual HEDIS and CAHPS processes across departments, ensuring compliance with NCQA, HCPF, and other regulatory requirements.
Serves as the subject matter expert for HEDIS/CAHPS, including managing technical specifications, overseeing supplemental data integration, and ensuring accuracy of measure reporting.
Partners with internal teams and external vendors to prepare, validate, and submit HEDIS and CAHPS data; troubleshoots issues and ensures timely resolution.
Monitors changes to HEDIS and CAHPS technical requirements and translate updates into operational workflows.
Provides consultation, education, and support across the organization on HEDIS and CAHPS processes, including accreditation and regulatory expectations.
Supports onboarding of new lines of business (LOBs), which may include full in-house administration of HEDIS and CAHPS processes.
Summarizes data, trends, and results from HEDIS and CAHPS to inform leadership, drive interventions, and improve organizational performance.
Develops tools, resources, and communication materials to support staff and providers in achieving quality performance related to HEDIS/CAHPS measures.
Maintains strong working relationships with internal leaders, providers, and vendors to ensure alignment on HEDIS and CAHPS priorities.
Facilitates and oversees day-to-day tactical operations of HEDIS/CAHPS cycles while anticipating and managing risks.
May participate in other enterprise-wide quality improvement initiatives as assigned, serving as a resource for process improvement, data-driven problem solving, and change management.
What you will bring:Education: Bachelor’s degree in healthcare related field required, including Public Health and Business Administration; An equivalent combination of education and experience can be substituted in lieu of degree. Master’s degree is preferred.Experience: Minimum of seven years’ progressive healthcare improvement or healthcare quality assessment required. Hands-on experience with HEDIS data and analytics is required. Experience leading and managing complex projects and experience in health insurance or health systems is preferred.Knowledge, Skills, and Abilities: Demonstrated knowledge working with National Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data and Information Set (HEDIS) and National Quality Forum (NQF) programs and measures. Demonstrated ability to think strategically about complex issues, develop recommendations, strategic objectives and action plans. Advanced knowledge of healthcare process improvement, project management and change management principles. Skilled in achieving project objectives through influence, critical thinking and collaboration, demonstrating a high-level of accountability and attention to detail. Demonstrates support for the company’s mission, vision and values. Position requires excellent verbal, written and presentation skills, strong organizational skills and teamwork skills. Must be proficient in MS Office applications (Word, Excel, Access, Power Point) and able to work with a variety of performance management, process improvement and project management tools. May be required to manage multiple priorities and projects with tight deadlines.Licenses/Certifications: Lean Six Sigma Greenbelt or Blackbelt preferred; Certified Professional in Healthcare Quality (CPHQ) preferred. A valid driver's license and proof of current auto insurance will be required for any position requiring driving.Together we will be: an innovative and collaborative team who supports each other, the employees and vision of the company to reach our goals individually, together and as an organization.Pay, Perks and Benefits at Colorado Access:The compensation for this position is $94,520.00 - $115,400.00 annually. Colorado Access has provided a compensation range that represents its good faith estimate of what Colorado Access may pay for the position at the time of posting. Colorado Access may ultimately pay more or less than the posted compensation range. The salary offered to the selected candidate will be determined based on factors such as the qualifications of the selected candidate, departmental budget availability, internal salary equity considerations, and available market information, but not based on a candidate’s sex or any other protected status.In addition to being part of a mission driven organization serving our community, as an eligible Colorado Access employee, you’ll receive a generous benefits package, that includes:
Medical, dental, vision insurance that starts the first day of the month following start date.
Supplemental insurance such as critical illness and accidental injury.
Health care and dependent care flexible spending account options.
Employer-paid basic life insurance and AD&D (employee, spouse and dependent).
Short-term and long-term disability coverage.
Voluntary life insurance (employee, spouse, dependent).
Paid time off
Retirement plan
Tuition reimbursement (based on eligibility).
Annual bonus program (based on eligibility, requirements and performance).
Where you will work:This position will be a hybrid model work environment, a blend of ‘In-Office’ and ‘Remote.’We are not able to support out of state employees at this time as we continue to serve our members and community in the metro Denver area and across the beautiful state of Colorado.