Program Manager, Clinical Quality

Blue Cross Blue Shield of MA

Boston, Massachusetts, US
Base: $98,910.00 - $120,890.00; bonus/equity: elig...
Hedis and hos measure management
Continuous quality improvement (cqi) leadership
Ncqa and cms regulatory standards knowledge
The role focuses on developing and coordinating quality improvement activities to optimize HEDIS, HOS, QCR, and Stars measures

Job Summary

  • The role focuses on developing and coordinating quality improvement activities to optimize HEDIS, HOS, QCR, and Stars measures.
  • Candidates must facilitate Continuous Quality Improvement initiatives and analyze data to drive performance outcomes while collaborating with internal stakeholders.
  • The position offers a competitive salary range of $98,910.00 - $120,890.00 along with comprehensive benefits including medical/dental/vision insurance and 401(k).

Matching Summary

The role focuses on developing and coordinating quality improvement activities to optimize HEDIS, HOS, QCR, and Stars measures.

Salary

Base: $98,910.00 - $120,890.00; Bonus/Equity: Eligible for variable pay; Benefits: Paid time off, medical/dental/vision, 401(k), well-being suite

Skills & Requirements

Must-have

  • HEDIS and HOS measure management
  • Continuous Quality Improvement (CQI) leadership
  • NCQA and CMS regulatory standards knowledge
  • Data analysis for quality performance outcomes
  • Stakeholder collaboration across clinical departments

Nice-to-have

  • Competitor and industry benchmark analysis
  • Evidence-based intervention development
  • Presentation skills to external audiences
  • Fast-paced dynamic organization adaptability
  • Prevention and wellness initiative leverage

Key Requirements

  • Bachelor's degree in clinical discipline required
  • Master's degree preferred or RN license
  • 3 years clinical experience or managed care quality improvement
  • CPHQ Certification a plus
  • Active Massachusetts license preferred

Work Rights

Not specified

Tailored Resume

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