Director, Provider Quality

Role Overview

• Lead and direct process improvement activities that provide more efficient and streamlined workflow
• Responsible for leading and collaborating with others on NCQA Accreditation and/or HEDIS performance
• Responsible for quality improvement aspects of risk adjustment processes for all products
• Collaborate with Medicare STARS team to improve overall STARS ratings
• Oversee provider satisfaction surveys and implement action plans for improvements
• Research and incorporate best practices into operations
• Organize and control activities, methods, and procedures to achieve business objectives
• Review and implement new technological tools and processes
• Present results of improvement efforts and ongoing performance measures to senior management
• Formulate and establish policies, operating procedures, and goals in compliance with internal and external guidelines

Requirements

• Bachelor's Degree Nursing, other related field or equivalent experience required
• Master's Degree preferred
• 7+ years of quality management, quality improvement or healthcare operations experience required
• Certified Professional in Health Care Quality preferred

Benefits

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• flexible approach to work with remote, hybrid, field or office work schedules