Health Plan Quality Administrator, Michigan

Position Summary

Responsible for routinely providing updates to all MIG quality staff and the applicable Quality Committees concerning recommendations and suggested courses of action pertinent to the efficient operation of the Quality Improvement Performance Plan (QPIP). Responsible for proposing targeted actions, aiding in the development of the interventions and coordinating the implementation of all quality operations. Coordinates specific regulatory and contractual responsibilities of assigned HMO including, but not limited to, HEDIS, CAHPS, NCQA Standard compliance, state performance projects, site audits and any other regulatory agencies.

Qualifications

• Required:
• Bachelor’s degree in health care, business or a related field.
• Four (4) years’ experience with a government regulated health organization or a managed care setting with at least two (2) years’ experience performing complex quality management activities including HEDIS, NCQA etc.
• PREFERRED:
• Master’s degree in health care related field.
• Six (6) years’ experience with a government regulated health organization or a managed care setting with at least three (3) years’ experience performing complex quality management activities including HEDIS, NCQA etc.
• Recent related work experience at an established HMO.

About Us

McLaren Health Care, headquartered in Grand Blanc, Michigan, is a $7.3 billion, fully integrated health care delivery system committed to quality, evidence-based patient care and cost efficiency. The McLaren system includes 12 hospitals in Michigan, ambulatory surgery centers, imaging centers, a 640-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering more than 732,838 lives in Michigan and Indiana, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, a National Cancer Institute-designated comprehensive cancer centers. McLaren has 20,000 full-, part-time and contracted employees and more than 113,000 network providers throughout Michigan, Indiana and Ohio.

Equal Opportunity Employer

McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.