Associate Program Manager, Quality Improvement (Healthcare)

Job Description

Job Description

Reporting to the Manager of Quality Improvement, the Associate Program Manager, Quality Improvement, is responsible for quality improvement analysis and regulatory oversight.

Your core projects include data analysis of clinical and care experience data to support quality improvement, managing a quality improvement program that meets regulatory standards, supporting SFHP’s cross-departmental efforts to improve quality in health plan outcomes and operations, partnering with providers to design tailored interventions aimed at improving quality outcomes, and implementing interventions across the city and county of San Francisco.

Please note that while SFHP supports a hybrid work environment, you are required to be onsite and in-office a minimum of 4 days per month.

This is a hybrid position, based in our Downtown San Francisco office.

Salary : $70,000 to $81,000 annual

WHAT YOU WILL DO :

• Coordinate major quality priorities by supporting quality measure identification, prioritization, and performing analysis based on regulatory requirements and NCQA standards.
• Review and interpret complex regulatory documents, including HEDIS & MCAS measure specifications from CMS and DHCS and measure steward and staying up to date with changes to QI program rules, measures, and measure specifications.
• Provide project management and organizational support in preparing deliverables and workplan timelines to the Quality Improvement team in preparing for SFHP’s journey to becoming a Dual Eligible Special Needs Medicare Advantage Plan.
• Maintain knowledge of applicable laws and regulations to ensure compliance with CMS, DHCS, DMHC and other applicable agency and program requirements.
• Schedule, plan, prioritize topics, and produce QI related materials to solicit feedback from the SFHP’s external groups including the Quality Improvement & Health Equity Committee, the Member Advisory Committee, provider network quality collaborative meetings and SFHP’s internal quality group the Quality Oversight Team.

WHAT YOU WILL BRING :

• Required : Bachelor’s degree in Public Health, Business, or other relevant areas, or equivalent relevant work experience.
• One year experience in project management or program management; experience in health care operations or quality improvement
• Desired : Master’s degree in healthcare field; experience working in health care delivery system or at a health plan.
• Familiarity in Model for Improvement, health care, managed care terminology, or Medi-Cal & Medicare.

WHAT WE OFFER :

• Health Benefits
• Medical : You’ll have a choice of medical plans, including options from Kaiser and Blue Shield of California, heavily subsidized by SFHP.
• Dental : You’ll have a choice of a basic dental plan or an enhanced dental plan which includes orthodontic coverage.
• Vision : Employee vision care coverage is available through Vision Service Plan (VSP).
• Retirement Employer-matched CalPERS Pension and 401(a) plans, 457 Plan.
• Time off 23 days of Paid Time Off (PTO) and 13 paid holidays.
• Professional development : Opportunities for tuition reimbursement, professional license / membership.

ABOUT SFHP :

Established in 1997, San Francisco Health Plan (SFHP) is an award-winning, managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-income residents in San Francisco County.

SFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 175,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services.

San Francisco Health Plan is proud to be an equal opportunity employer. We are committed to a work environment that supports, inspires, and respects all individuals and in which our people processes are applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristics.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

San Francisco Health Plan is an E-Verify participating employer.

Hiring priority will be given to candidates residing in the San Francisco Bay Area and California.

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