Universal Healthcare MSO, LLC · 2 days ago
Manager of Quality Improvement- Bakersfield 1.2
Bakersfield, CA
Full-time
Onsite
Mid, Senior Level
$38.60/hr - $48.24/hr
3+ years expUniversal Healthcare MSO, LLC is seeking a Quality Manager responsible for overseeing the organization’s Quality Improvement activities. This role includes ensuring compliance with standards, supervising staff, and managing quality-related projects to improve healthcare outcomes.
Hospital & Health Care
Responsibilities
Supervise and manage the work of clinical quality coordinators, risk adjustment coders, and other quality-related staff, including monitoring productivity, accuracy, and compliance with organizational standards
Provide coaching, training, onboarding, and performance feedback to staff, fostering professional growth and accountability
Assign and balance workloads for staff, ensuring timely completion of cases, tasks, and reports
Monitor staff documentation in EZCAP/EZCARE or other systems for accuracy, timeliness, and regulatory compliance
Conduct periodic quality checks and audits of staff work to ensure accuracy and adherence to requirements
Track and report on staff productivity metrics; identify trends, address performance issues, and implement improvements to maintain efficiency and quality
Address escalated issues from staff, providers, and internal departments, resolving routine operational problems and escalating complex issues to the Quality Director or Medical Director as appropriate
Coordinate and monitor execution of the Quality Improvement Program (QIP), including the QI Program Description, Annual Evaluation, and QI Work Plan
Track timelines and ensure deliverables are met for HEDIS, Stars, QIPs, CCIPs, and other quality initiatives
Facilitate the internal Quality Improvement Workgroup, monitoring progress on interventions and supporting cross-departmental initiatives
Support preparation of Quality Improvement Committee (QIC) and governance committee materials; present findings internally and escalate external reporting to the Quality Director
Conduct root cause analyses on performance gaps, support corrective action plans and track progress through measurable outcomes
Oversee quality-of-care grievance intake, tracking, and investigations; ensure timely escalation and resolution
Collect, validate, and report quality data in collaboration with Data Analysts; prepare draft dashboards, scorecards, and provider reports for leadership review
Monitor provider performance on quality metrics and assist with dissemination of provider education materials and scorecards
Coordinate audit readiness activities, including documentation, evidence collection, and submission for HEDIS audits, delegation oversight, and CMS/DHCS reviews
Act as an operational liaison between Quality and Utilization Management, Case Management, and Population Health teams to ensure coordination of care gap closure and chronic disease improvement initiatives
Identify recurring performance or compliance issues and escalate trends to the Quality Director for systemic resolution
Support committee operations by preparing agendas, materials, minutes, and follow-up trackers to ensure accountability for action items
Support preparation of member and provider communications related to quality initiatives as directed by the Quality Director
Maintain awareness of regulatory updates and contribute to the translation of requirements into operational workflows
Qualification
Required
Bachelor's degree in nursing, Public Health, Healthcare Administration, or related field
3 years of managed care or healthcare quality experience
Minimum of 2 years of supervisory or people leadership experience
Demonstrated ability to manage staff performance, monitor productivity, and ensure quality deliverables
Strong people leadership skills with the ability to supervise, coach, and evaluate staff
Skilled in monitoring productivity, conducting quality checks, and ensuring compliance with organizational and regulatory standards
Excellent organizational and time management skills with the ability to manage multiple priorities
Ability to interpret and use quality and performance data (HEDIS, Stars, grievances) to inform interventions
Strong collaboration skills with UM, PHM, and Provider Relations to improve outcomes and close care gaps
Ability to identify barriers to quality performance and recommend workflow or process improvements
Adaptable to evolving CMS, DHCS, and NCQA requirements; able to operationalize changes efficiently
Awareness of health equity and cultural considerations in quality initiatives and provider engagement
Effective communicator with strong oral and written skills, able to present clearly to staff and leadership
Strong interpersonal skills with the ability to collaborate across teams, providers, and health plan partners
High attention to detail, accuracy, and follow-through
Proficient in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)
Preferred
Knowledge of health plan performance and HEDIS, HOS, CAHPS and CMS Stars measures preferred
Master's degree (MPH, MHA, MSN, MBA) preferred
Active RN license in California preferred
Certified Professional in Healthcare Quality (CPHQ) preferred
Familiarity with platforms such as Cotiviti, EZCAP/EZCARE, Tableau, or Power BI preferred
Benefits
Medical
Dental
Vision
Paid Time Off (PTO)
Floating Holiday
Simple IRA Plan with a 3% Employer Contribution
Employer Paid Life Insurance
Employee Assistance Program
Company
Universal Healthcare MSO, LLC
Universal Healthcare MSO is a full service management services organization providing IPA management services to Universal Healthcare IPA, Inc.
11-50 employees
Funding
Current Stage
Early StageLeadership Team
Michael Myers
Chief Executive Officer
Jeff Mihal
Chief Financial Officer
Company data provided by crunchbase