
Quality Performance Improvement, (QPI) Manager - Remote
- Seattle, WA
- $89,900-160,600 per year
- Permanent
- Full-time
Program Management & Development
- Design, implement, and manage the health plan's Quality Performance Improvement Program (QPIP)
- Lead the development and execution of PIPs and QIPs in accordance with state and federal guidelines
- Develop and maintain policies and procedures related to quality improvement
- Monitor and analyze quality performance metrics (e.g., HEDIS, CAHPS, CMS, NCQA)
- Use data to identify trends, gaps, and opportunities for improvement
- Develop dashboards and tracking tools to monitor progress and outcomes
- Collaborate with internal teams and external providers to design and implement evidence-based interventions
- Evaluate the effectiveness of interventions and adjust strategies as needed
- Provide technical assistance and training to providers and staff
- Prepare and submit formal quality reports to state agencies, including annual QIPs and PIPs
- Ensure compliance with all regulatory and accreditation requirements
- Serve as the primary point of contact for state quality audits and reviews
- Facilitate cross-functional quality improvement committees and workgroups
- Communicate quality goals, progress, and outcomes to internal and external stakeholders
- Foster a culture of continuous quality improvement across the organization
- 5+ years of experience in healthcare quality improvement, preferably within a managed care or health plan setting
- Project management experience, manage timelines, create chapter, manage end to end, timelines
- Solid knowledge of HEDIS, CAHPS, CMS, NCQA, and state Medicaid/Medicare quality requirements
- Experience with data analysis, performance measurement, and quality improvement methodologies (e.g., PDSA, Lean, Six Sigma)
- Proficiency in Microsoft Office Suite and data visualization tools (e.g., Excel, Power BI, Tableau)
- Advanced level proficiency with Excel
- Adhere to PST work schedule
- Certification in healthcare quality (e.g., CPHQ)
- Experience managing state-submitted quality improvement projects
- Familiarity with value-based care and population health strategies
- Reside in the state of Washington
- Excellent written and verbal communication skills, especially in formal reporting