Program Manager (Job ID: 1199), MVP Health Care

Posted: 03/13/18 | SHARE:


MVP Health Care is a nationally-recognized, regional not-for-profit health plan.  We are committed to having a positive impact on the health and wellness of everyone and every community we serve. We care for more than 700,000 members across New York and Vermont, and we are powered by the ideas and energy of more than 1,600 employees – providing a wide range of health benefit plan options with attentive service and flexibility normally associated with a smaller company.  Stop settling for “just a job,” and join a company where you can reach your full potential…and make a positive difference!

The Quality Improvement (QI) Program Manager: Oversees multiple high visibility quality improvement projects that require coordination with various departments to assure continuous communication and collaboration across related stakeholders, drive broad-scale sustainable improvement, and ensure stated goals and objectives, including compliance with Centers for Medicaid and Medicare Services (CMS), the NYS Department of Health (DOH) and the National Committee for Quality Assurance (NCQA) health plan accreditation standards are met. Obtains and analyzes data required for NCQA accreditation standards, HEDIS/QARR measures, and/or CMS Star quality ratings, interprets these findings, identifies barriers to improvement and propose methods for addressing these barriers. Assists in the NYSDOH QARR action plan, NYSDOH Performance Improvement Projects, NYSDOH and VT Quality Improvement Strategies, and CMS Quality Improvement Projects. Acts as a resource to internal departments for the development and evaluation of programs that support increased quality outcomes. Respond to member quality complaints and concerns per state and federal regulatory requirements. Coordinates the collection of data and information and participates in the writing of the QI Annual Report, QI Program Description and QI policies and procedures.

Participates in site visits as required for accreditation/regulatory agencies.

• Some travel including periodic overnight stays will be required.

Respond to other ad hoc requests for written documentation as needed, and perform other duties as assigned by management.




Minimum Education:

Bachelor’s degree in Business Administration or related field preferred: equivalent amount of education and related experience may be considered.

Minimum Experience:

Three to five years of progressive experience in purchasing, contract management or related area, or equivalent combination of education and experience.

 Required Skills:

• Strong negotiation skills

• Excellent interpersonal and customer-focused communication skills. Ability to communicate with all levels of organization.

• Ability to use discretion in handling confidential information

• Demonstrated organizational skills and problem solving abilities

• Ability to prioritize multiple assignments and work independently to meet deadlines.

• Good written skills and the ability to work with RFP and other PCM documents.

• Knowledge of contracting principles and procedures applicable to pre-award and/or post-award actions pertinent to procurement and/or administration of contracts.

• Must be proficient in contract standards and language.

• Must possess strong computer skills to utilize MS Word, Excel and Outlook software, plus knowledge of purchasing applications. Lawson preferred or other major system experience. 



Minimum Education: 

Bachelor’s Degree in Actuarial Science or related field. Additionally, successful completion of at least one Actuarial Exam is required with aspirations of attaining Associateship or Fellowship in the Society of Actuaries.

Minimum Experience: 

Internship or full-time work experience in a business setting preferred.

Required Skills:
• Self-motivated individual with strong analytical skills
• Ability to prioritize multiple tasks and work in time-sensitive environment
• Ability to work independently as well as work effectively as a member of a team
• Ability to solve complex problems
• Demonstrated problem-solving and analytical abilities.
• Interpersonal and customer-focused communication skills


Additional Information

Status: Full-time, Exempt

MVP Health Care is an Affirmative Action/Equal Opportunity Employer). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency, protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at

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