Manager - Quality/HEDIS Program Management

Overview

Presbyterian is seeking an experienced healthcare leader to oversee the daily operations of our Performance Improvement team.

 

The Manager of Quality & Performance Improvement will: Provide leadership for complex, multi-departmental clinical and business programs, Drive performance improvement initiatives and ensure regulatory compliance, Coach, mentor, and lead team members to achieve clinical, operational, and fiscal goals, Ensure accreditation and quality standards are consistently met across departments

• Full Time - Exempt: Yes
• Job is based at Rev Hugh Cooper Admin Center
• Work hours: Days

Preferred Qualifications

• Experience designing and/or operationalizing population health or quality programs (HEDIS, Medicare STARs).
• Experience using data to drive decision making and formulating analysis questions.
• Experience working in healthcare – either health plan or delivery.

This is a key leadership role for a results-driven professional with a passion for quality, patient safety, and continuous improvement in healthcare.

Qualifications

• Bachelor s degree in Business, Nursing, Healthcare, or related field, Masters preferred.
• Minimum of five years direct experience building, developing, coaching and mentoring teams across multiple disciplines. Experience in the healthcare/managed care industry with a focus on regulatory compliance and/or auditing required.
• Program management experience in the areas of NCQA accreditation and/or HEDIS/CMS Star performance measurement systems required.
• Experience developing, implementing and evaluating clinical interventions preferred.

Responsibilities

• In collaboration with the Director/Executive Director, manages the overall direction, coordination, implementation, execution, and completion of specific clinical & quality programs ensuring consistency with company strategy, commitments, and goals
• Sets and manages program expectations, frequency and content of status reports to track programs milestones and deliverables, and develops best practices and tools for program execution and management
• Determines the resources and participants needed to achieve goals
• Builds and develops collaborative relationships vital to the success of programs. Negotiates with other department managers/directors to obtain the required participants from within PHS
• Delegates tasks and responsibilities to manage dependencies and critical path resulting in program activities completed on time and within budget
• Responsible for interviewing, hiring, coaching, and mentoring staff. Provides relevant training and education opportunities and performance feedback. Responsible for annual performance evaluations for all direct reports

Benefits

About Presbyterian Healthcare Services

Presbyterian offers a comprehensive benefits package to eligible employees, including medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits.

 

The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities—like challenges, webinars, and screenings—with opportunities to earn gift cards and other incentives.

 

As a mission-driven organization, Presbyterian is deeply committed to improving community health across New Mexico through initiatives like growers' markets and local partnerships.

Founded in 1908, Presbyterian is a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group. With nearly 14,000 employees, it is the largest private employer in the state, serving over 580,000 health plan members through Medicare Advantage, Medicaid, and Commercial plans.

 

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Maximum Offer for this position is up to

USD $56.92/Hr.

Compensation Disclaimer

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.