Director, Quality Improvement

» Director, Quality Improvement
Healthcare
in Little Rock
, AR
Reference: 19-03509

Position Purpose:

  • Lead and direct process improvement activities that provide more efficient and streamlined workflow
  • Responsible for leading and collaborating with others on National Committee for Quality Assurance (NCQA) Accreditation and/or Healthcare
  • Effectiveness Data and Information Set (HEDIS) performance
  • Responsible for quality improvement aspects of risk adjustment processes for all products
  • Collaborate with Medicare STARS team to improve overall STARS ratings for Medicare products (including HEDIS, CAHPS, HOS)
  • 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 and fosters team concept with internal and external constituencies

For PA H&W Only:

  • Responsible for overseeing reporting and outcome measurement and HEDIS data collection, serving as point person between the department and the department’s EQR contractor

License/Certificates:

  • Certain states may require a formal certification in quality improvement, risk management, or another parallel field
  • Current state’s RN license preferred
  • Certified professional in healthcare quality preferred

Non-Negotiable Requirements: 

  • Lead and direct process improvement activities that provide more efficient and streamlined workflow
  • Bachelor’s degree in Nursing, related clinical degree or equivalent experience
  • Masters degree preferred
  • 7+ years of quality management, quality improvement or healthcare operations experience
  • Leading and collaborating with others on National Committee for Quality Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set (HEDIS) performance Quality improvement aspects of risk adjustment processes for all products
  • Prior work with Medicare management