Samaritan Health Services · 18 hours ago
Health Plan Program Manager I - Quality Improvement & Population Health
United States
Full-time
Remote
Entry, Mid Level
$30/hr - $45/hr
2+ years expSamaritan Health Services provides health insurance options to various members and employers. The Program Manager I is responsible for translating health plan quality and population health strategies into measurable outcomes, serving as a bridge between various operational teams to ensure data-driven performance improvement initiatives.
Health CareHospital
Responsibilities
Partners closely with Providers to ensure provider awareness, education, and engagement around quality and utilization performance expectations
Lead development and maintenance of standardized provider scorecards that integrate quality, utilization, and outcome-based KPIs
Translate analytic outputs (PowerBI and other reporting tools) into actionable insights for providers and internal stakeholders
Coordinate cross-functional quality improvement initiatives, including HEDIS, Stars, CCO incentive measures, and performance improvement projects (PIPs)
Support Quality Improvement Committee (QIC) operations, including agenda planning, performance reporting, and tracking of improvement objectives
Facilitate provider and vendor meetings to drive accountability, remove barriers, and ensure follow-through on improvement plans
Ensure compliance with CMS, OHA, and NCQA requirements related to provider feedback, performance monitoring, and documentation
Develop and deliver provider education materials and campaigns aligned with organizational priorities and health literacy standards
Track progress on initiatives, prepare reports, and maintain documentation to support regulatory audits and leadership decision-making
Collaborate with Care Coordination, Pharmacy, Product, and Analytics teams to align quality and utilization strategies
Qualification
Required
Bachelor's Degree in a related field or equivalent experience required
Two (2) years experience in a health related field required
Experience in leadership principles, practices, policies, procedures and regulations as they relate to assigned program(s) required
Experience and/or training in computer applications, including word processing and spreadsheet software, required
Preferred
Experience in health plan quality improvement, population health, or provider performance management strongly preferred
Knowledge of CMS Medicare Advantage, HEDIS/Stars, and/or Oregon CCO quality programs preferred
Company
Samaritan Health Services
Samaritan Health Services provides compassionate, innovative and quality health care serving communities.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Marty Cahill MBA, FACHE
Chief Executive Officer
Brandon Schmidgall
Chief Operating Officer
Recent News
Fierce Healthcare
2025-10-27
2025-05-25
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