This Jobot Job is hosted by: Mohammed Chowdhury
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Salary: $130,000 – $150,000 per year
A bit about us:
Reputable and life changing community health organization in need of a Senior Director of Quality Management!
The ideal candidate is responsible for operations, financial and quality performance of Health System’s Outcomes Department based on Value Based Care model. The position is responsible for directing and overseeing all quality improvement, regulatory compliance and risk management processes and initiatives for organizations facilities including, active involvement in reporting data and project-based work as directed, and develop and implement care management programs.
- Serves as a leader of the organizations Quality strategy and activities, including but not limited to leadership of
Quality
committees and oversight of intervention activities intended to improve quality measures and outcomes.
- Directly supervises the Quality team.
- Collaborates with internal and external customers to conduct data collection, reporting and monitoring for key
Quality performance measurement activities.
- Oversees and help coordinate the implementation of NCQA accreditation surveys and federal QI compliance
activities.
- Collaborates with other departments to ensure appropriate data collection, storage and reporting of quality
performance metrics such as HEDIS, CMS Quality Payment Program metrics and Star Ratings (as applicable),
and standardized core quality measures (CQMs).
- Responsible for Medicare Stars strategies and performance improvement.
- Designs, implements, monitors and analyzes the effectiveness of a comprehensive Quality intervention strategy
and facilitates stakeholder input and strategic direction
- Serves as operations and implementation lead for the quality improvement activities utilizing a defined
roadmap, timeline and key performance indicators.
- Communicates with the CEO, CPoH and Senior Leadership Team about key deliverables, timelines,
barriers and escalated issues that need immediate attention.
- Communicates with Legacy’s leaders to establish QI benchmarks and requirements for VBC contracts.
- Responsible for developing the local Medicare Stars work plan and executing on interventions that will improve
CAHPS, HEDIS and HOS scores. Also responsible for monitoring Part D and Operational health insurance
metrics and coordinating with centralized teams to improve these metrics.
- Collaborates with the Analytics department for broad-based quality data analytics. Oversees efforts to develop
broad-based quality data analytics to support ongoing, real-time VBC contract requirements.
- Collaborates with Analytics department for HEDIS abstraction for required VBC customized reports to meet
VBC network contract obligations.
- Presents summaries, key takeaways and action steps regarding the organization’s quality strategy to
key stakeholders.
- Assist with the creation of policies and procedures and standard operating procedures
- Ensure compliance with program requirements
- Promotes smooth day to day operations of the department through continued evaluation of staffing needs,
volumes, utilization of various resources and funding
- Promotes compliance with all state, federal regulations, grant requirements and Managed Care Organization
contract requirements and Patient Centered Medical Home (PCMH) standards
- Serves as a subject matter expert for quality management efforts within the organization
- Integrates the quality metrics related to PCMH certification, various grants, MCOs and other payors into the
integrated care management efforts.
- Collaborates with leaders in order to promote efficient and purposeful integration of services for the patient.
- Creates quality reports related to integrated care efforts to be submitted to Legacy committees and various
grants as required
- Handles complaints related to the functioning of the Health Outcomes Support and identifies appropriate
action steps to minimize further opportunities for incidents
- Collaborates and maintains good working relationships with other departments, grant administrators,
community service organizations, public agencies, MCOs, other payor groups, hospitals and pharmacies
- Conducts monthly employee staff meetings for the Health Outcomes Support Department for the purpose of
reviewing work progress, integrated care dashboards, and other reports related to department
- Special projects as approved/assigned.
If you would like to discuss more specifics regarding this role, please contact me directly by applying below or sending a confidential resume to https://apply.jobot.com/jobs/senior-director-of-quality-management-healthcare/632189360/?utm_source=Monster
Why join us?
Benefits include:
- Incredible Health Insurance for individuals and family (Health/Dental/Vision insurance)
- PTO
- Much more!
Requirements:
- Bachelor of Science in Nursing or comparable degree
- 5 years of quality leadership experience in a managed care setting
- 3-5 years in quality compliance/HEDIS operations, including metrics and performance standards
- NCQA experience
- Experience with utilization of national quality measures and quality improvement initiatives
- Experience in project management
- Experience with all patient populations and lines of business (Medicaid, Medicare, Commercial)
- Current Registered Nursing License – State of Texas
Job Details
If you would like to discuss more specifics regarding this role, please contact me directly by applying below or sending a confidential resume to https://apply.jobot.com/jobs/senior-director-of-quality-management-healthcare/632189360/?utm_source=Monster
Interested in hearing more? Easy Apply now by clicking the “Apply” button.
Source: Monster.com
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