Quality Program Manager-Senior

Now hiring a Quality Program Manager-Senior

Anticipates, develops and implements health management programs and initiatives. Achieves clinical and fiscal improvements for their identified programs. Meets regulatory requirements.

How you belong matters here.

We value our employees' differences and find strength in the diversity of our team and community.

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us

• Full Time - Exempt: Yes
• Job is based Rev Hugh Cooper Admin Center
• Work hours: Days
• Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.

Ideal Candidate: Masters Degree, 3 years professional experience with 1 year quality experience or 3 years RN experience

• Bachelors degree in Business, Nursing, Healthcare, or related field, Masters preferred.
• 3 years professional experience with 1 year quality experience or 3 years RN experience.
• Compliance with specifics to Healthcare accreditation and CMS
• Managed Care and awareness enterprise operations, functions & processes
• MS Office
• Adobe Pro
• Visio

• Develop and analyze reports, program plans and milestones
• Utilizing quality tools, identifies, develops, builds, and initiates evidence based programs for improving health outcomes for specifically delineated programs or populations
• Creates and updates work plans, tasks, timelines, and measurements.
• Selects article topics and reviews draft articles for providers and members
• Works with identified stakeholders regarding compliance
• Performs outcomes assessments
• Identifies & resolves issues, escalates as necessary
• Facilitates collaboration throughout the health plan and external organizations, to optimize the success of population health management activities using input and resources from the appropriate business units
• Negotiates with vendors and collaborates with contracted network providers, various coalitions, community organizations, etc.
• Utilizes organization s strategic plans to develop, monitor, and report program plans and milestones.
• Recognizes change in the managed care environment and develops responsive initiatives
• Compiles and presents summaries of health management activities in a professional format to the appropriate internal or external entities.
• Performs other functions as required

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

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

USD $44.49/Hr.

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.