Job Description

The Director of Quality interfaces and partners with the Quality Management leadership team and cross functional business partners to provide expertise in how to drive quality performance, HEDIS specification, and analytical support for clinical quality projects, including opportunity identification, performance, and reporting to appropriate regulatory bodies and health plans, program design, impact analysis, and program evaluation.

 

This individual will oversee all aspects of HEDIS production and state performance measures including data extraction, processing, medical record review, survey, audit, and report submission to regulators.  They will deliver contractual quality reporting to provider partners timely to improve quality ratings and Pay for Performance programs.  Identify, in collaboration with Clinical Quality teams, a set of quality care metrics to be produced regularly.  Develop and deliver these metrics on pre-determined schedules.  Provide consultation to Clinical Quality teams for quality improvement programs design and development. Support implementation of clinical quality projects, including estimating size of the population, potential impact, monitoring progress, reporting and evaluation. Provide, in collaboration with Clinical Quality teams, requirements for clinical quality data infrastructure to support clinical quality measurement and reporting activities.

 

Health Choice exists to improve the health and well-being of the individuals we serve through our health plans, integrated delivery systems and managed care solutions. We strive to recruit and retain only the finest health care professionals with the highest levels of integrity, compassion and competency. If you are driven by your own personal commitment to these values and desire to work in a team-focused, collaborative and supportive environment - while still being valued for your individual strengths - Health Choice is the place for you.

Equal Opportunity Employer Minorities/Women/Veterans/Disabled



Qualifications

Minimum Requirements:

Bachelor's degree

Seven (7) years in health care quality focused roles

Strong analytic skills and the ability to translate complicated data into useable information, including analysis of practice variation

 

Preferred Qualifications:

Master's degree

Significant experience in analytic functions, quality assessment, HEDIS measurement, use of claims data, medical record review and clear advancement in responsibilities and outputs

 

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

Apply Online