About this role
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 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.