at St. Luke's Health System in Boise, Idaho, United States
Job Description
At St. Luke’s, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke’s is truly a great place to work.
As a Quality Manager, you’ll lead critical quality reporting and compliance initiatives that influence organizational performance, member outcomes, and success across programs like CMS Stars and other quality rating systems. Working across the Health Plan, Health System, and provider network, you’ll partner with leaders, clinicians, analysts, and vendors to deliver results and drive continuous improvement.
What You Can Expect:
- Lead annual quality reporting operations across Medicare, Commercial, and Exchange lines of business.
- Oversee data collection, validation, and regulatory submissions to ensure accuracy, compliance, and audit readiness.
- Manage medical record review operations, including vendor partnerships, retrieval strategies, abstraction, and submission processes.
- Lead NCQA audit preparation, documentation, and compliance activities.
- Partner with analytics, IT, and operational teams to enhance reporting, data integration, and measurement accuracy.
- Identify and implement process improvements that streamline workflows and improve performance.
- Monitor performance throughout the year and help drive results across CMS Stars, Quality Rating Systems, accreditation efforts, and other key quality initiatives.
- Collaborate with provider, clinical, operational, network, and risk adjustment teams to improve documentation, coding accuracy, gap closure, and overall outcomes.
- Stay ahead of regulatory and industry changes impacting quality measurement and reporting.
- Lead, coach, and develop a high-performing team while overseeing the full employee lifecycle.
Qualifications:
- Education: Bachelor’s degree or experience in lieu of degree
- Experience: Five (5) years’ relevant experience
Preferred Qualifications:
- Health system experience, integrated health plan/health system experience preferred
- Health Plan HEDIS experience
- Leadership experience
- Epic experience
At St. Luke’s, caring for people in the communities we serve is our mission – and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Personify Health Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals.
St. Luke’s is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law.
*Please note: this posting is not reflective of all job duties and responsibilities and is intended to provide an overview to job seekers.
To view full details and how to apply, please login or create a Job Seeker account