Supervisor, Quality Improvement

Salary Range:  $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.)

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

Job Summary

The Supervisor of Quality Improvement (QI) is responsible for monitoring the quality Improvement staff and works with leadership to supervise the day to day activities of the quality improvement staff, to ensure that all aspects of the QI program are met e.g. regulatory compliance with Centers for Medicare and Medicaid Services (CMS), Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC), National Committee for Quality Assurance (NCQA) etc.   

This position supervises all aspects of running an efficient  teams, including hiring, supervising, coaching, training, disciplining, and motivating direct and indirect staff reports.  This position will supervise quality improvement staff to keep up with all standards of practice, clinical guidelines and regulatory requirements and will adjust processes/activities to ensure compliance for operational processes/activities.   Critical to the position is supervise the execution of interventions, evaluations, and performance improvement projects, ensuring the external policies/regulations and are completed timely, at the highest quality and integrity. 

Duties

Supervises the day to day activities of the quality improvement activities, including collection and analysis of data. Ensures that measures are prioritize and interventions are addressing root causes and  are methodologically sound,  reported and tracked accurately in a timely manner, including day to day activities related to, management and monitoring of project management staff. 

Responsible for the daily workflow and leading the work of assigned staff.  This role will mentor, coach, act as a resource and provide feedback on performance of assigned staff.

Provides oversight and review of projects and recommends resolutions in the review of complex  operational decisions.

Conducts and/or develops operational educational in-services to improve quality improvement interventions 

Maintains all assigned reporting responsibilities. Supervises operational discussions with a variety of contributors and stakeholders from internal and external customers to identify gaps, resolve issues and improve processes. 

Participates/ supports in the scheduled regulatory audit process as needed.  

Monitors and evaluates operational compliance with quality improvement activities, clinical review and reports appropriate information to appropriate committees and the governing body.

Performs ongoing monitoring and evaluation of departmental operations with internal and external stakeholders to lead quality performance.

Monitors and communicates to higher management any barriers to completing assignments or daily work in an efficient and effective manner while maintaining confidentiality in compliance with all HIPAA requirements.

Works collaboratively with QI leadership regarding operational issues.

Performs others duties as assigned.

Duties Continued

Education Required

Bachelor's Degree in Public Health or NursingIn lieu of degree, equivalent education and/or experience may be considered.

Education Preferred

Master's Degree

Experience

Required:

At least 5 years of quality improvement experience in a managed healthcare setting and/or quality improvement experience that includes Medicare, Medi-Cal, and other government programs.

At least 2 years of leading process, program, or staff or supervisory experience.

Strong Experience with regulatory compliance such as CMS, DMHC, DHCS, and NCQA.

Active experience in the Plan-Do-Study-Act process.

Experience in compliance, accreditation, service or quality improvement.

Advance Experience in facilitating workgroups and project management.

Equivalency:  Completion of the L.A. Care Management Certificate Training Program may substitute for the supervisory/management experience requirement.

Preferred: 

Advanced experience in complex project management.

Skills

Required: 
Competently make decisive high-quality decisions in the absence of leadership.

Ability to provide balanced feedback at the most critical times with excellent and effective communication and writing skills.

Ability to maintain positive working relationship to work effectively with various levels of organization and external agencies.

Ability to lead Project Management staff to highest performance standards by demonstrating accountability to self, and trust and respect of others.

Ability to lead staff to apply time management and milestones to diligently track and manage work progress.

Ability to prioritize and set aside less critical tasks, and develop contingency plans to address barriers encountered.

Knowledge of NCQA, CMS, Department of Health Services (DHS) and Health Plan standards, and a high level of responsibility for disciplinary proceedings.

Licenses/Certifications Required

Licenses/Certifications Preferred

Registered Nurse (RN) - Active, current and unrestricted California LicenseCertified Professional in Healthcare Quality (CPHQ)

Required Training

Physical Requirements

Light

Additional Information

Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.  The range is subject to change.

L.A. Care offers a wide range of benefits including

• Paid Time Off (PTO)
• Tuition Reimbursement
• Retirement Plans
• Medical, Dental and Vision
• Wellness Program
• Volunteer Time Off (VTO)

Nearest Major Market: Los Angeles
Job Segment: Nursing, Registered Nurse, Medicare, Public Health, Medicaid, Healthcare