Manager, Quality Performance and Outreach (STARS/ CAHPS/ PWP/ HEDIS)- Remote

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans is hiring for a Manager, Quality Performance and Outreach (STARS/ CAHPS/ PWP/ HEDIS)- Remote! Status: Full-time, permanent position (40 hours) Standard working hours: 8am to 5pm EST, M-F. Location: Remote opportunities available in the following states: Virginia, North Carolina, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, Wyoming

Overview

• The Manager, Quality Performance and Outreach plays a critical role in driving strategic initiatives to improve STARS, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Performance Withold Program (PWP), and Healthcare Effectiveness Data and Information Set (HEDIS) performance across the health plan and enterprise.
• Reporting directly to the Director, Quality Performance and Outreach, this position leads cross-functional efforts to design, implement, and evaluate outreach and quality improvement programs that enhance member experience, close care gaps, and support regulatory compliance.
• The position focuses on all lines of business, including Commercial, Medicaid, and Medicare, collaborating with other health plan departments, providers, vendors and the enterprise.
• The position will manage a Team of 4 Direct Reports

Education

• Bachelor’s degree in Nursing, Clinical Sciences, Population Health, Healthcare Administration, Business Administration, or related field REQUIRED

Certification/Licenses

• Registered Nurse License in Virginia OR Compact/Multi-state preferred

Experience

• 3 years of experience with HEDIS, STARS, PWP, or Clinical Improvement REQUIRED
• 3 years of supervisory or management experience REQUIRED
• Prior experience in Project Management and Performance Improvement preferred
• Strong project management and cross-functional collaboration skills REQUIRED
• Ability to interpret clinical data and translate insights into actionable strategies REQUIRED
• Experience working with vendors and managing outreach campaigns REQUIRED
• Health Plan experience is preferred

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees. Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals. We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all to help our members improve their health. Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth. Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve! To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-98308 #Indeed Talroo - Health Plan Keywords: Health Plan, Healthcare, Health Insurance, MCO, Managed Care, Medicaid, Medicare, DSNP, Commercial, Group insurance, Remote, Virginia, VA, Quality, Performance, STARS, Consumer Assessment of Healthcare Providers and Systems, CAHPS, Performance Withold Program, PWP, and Healthcare Effectiveness Data and Information Set, HEDIS, North Carolina, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, Wyoming Benefits: Caring For Your Family and Your Career

• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down – $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development

•Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Apply tot his job Apply To this Job