Quality Program Manager-Senior-CISC

Location Address:

Compensation Pay Range:

Summary:

Responsibilities:

CISC Quality Program Manager is responsible for overseeing the implementation and evaluation of program activities that address the unique health needs of children in state custody. This role ensures compliance with regulatory requirements, drives quality improvement initiatives, and monitors performance metrics to achieve optimal outcomes for this vulnerable population. Key responsibilities include health education planning, health improvement strategy development, data analysis, and reporting to executive leadership.

Some key responsibilities include
* Lead the development and implementation of in-depth analysis of comprehensive reports, strategic program plans, and milestone tracking to enhance performance metrics for children in state custody.
* Utilize quality improvement tools to identify gaps and develop evidence-based interventions aimed at improving health, behavioral, and social outcomes for this vulnerable population.
* Facilitate collaboration throughout the health plan and external organizations, to optimize the success of population health and quality management activities using input and resources from the appropriate business units.
* Create and maintain detailed work plans, timelines, and measurable objectives specific to CISC initiatives.
* Manages strategy, inputs, and outputs from contributors to the health plans quality improvement process- including developing health education activities, quality improvement activities, and performance improvement plans when necessary.
* Serves as the managerial lead for CISC quality and population outcomes, providing direction, performance coaching, and accountability across internal teams and delegated partners.
* Establishes and socializes a CISC outcomes narrative that clearly demonstrates health improvement and value (e.g., HEDIS, child welfare measures, evidencebased service utilization, equity gaps closed) to executive leadership and external oversight bodies.

Qualifications:

• Preferred Education:
• MPH (Master of Public Health) - Focus in Health Policy & Management, Epidemiology, or Maternal & Child Health
• MHA (Master of Health Administration) with experience in quality, compliance, and managed care, MSW (Master of Social Work) - Clinical or Administration track, with child welfare emphasis or MSN/MPH (Nursing + Public Health)
• Preferred Experience:
• 3 years of experience in health plan administration roles.
• Strong Education and Experience Alternatives:
• * MSW/MBA (Healthcare concentration) - if the role leans into analytics, operations, and executive-level performance management. Or;
• * Undergraduate Degree, And: Public Health, Social Work, Psychology, Nursing, Healthcare Administration, or Data Analytics, with managed care experience and 5 years of relatable work experience.
• Supplemental Certificates Preferred but Not Required:
• CPHQ (Certified Professional in Healthcare Quality) - gold standard for quality improvement tools and methodologies, Lean Six Sigma - Green Belt (minimum) / Black Belt (preferred) for CQI cycles, workflows, and reducing variation. HEDIS/NCQA- Any formal training or certificates (e.g., NCQA Quality Oversight or HEDIS compliance workshops). PMI-PMP or CAPM - if program planning, milestone tracking and complex stakeholder management are core deliverables. Data tools: Intermediate/Advanced Excel, Power BI/Tableau, and familiarity with SQL or SAS is a strong plus.

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.