Director, Quality Improvement – Digital Quality Measurement

This is a fully remote position, open to applicants in Missouri.

📋 Description

• Lead and oversee process enhancement initiatives to develop more efficient and streamlined workflows.

• Design and implement the organization's strategy for digital quality measurement.

• Direct and collaborate on NCQA Accreditation and/or HEDIS performance efforts.

• Manage quality improvement elements of risk adjustment processes across all product lines.

• Work in conjunction with the Medicare STARS team to enhance STARS ratings, including HEDIS, CAHPS, and HOS metrics.

• Supervise provider satisfaction surveys and execute action plans for improvement.

• Investigate and integrate best practices into operational processes.

• Organize and manage activities, methodologies, and procedures to meet business goals.

• Evaluate and deploy new technological tools and processes.

• Promote team collaboration with both internal and external stakeholders.

• Present improvement outcomes and ongoing performance metrics to senior leadership.

• Develop and establish policies, operating procedures, and objectives in accordance with internal and external standards.

• Lead the strategy, roadmap, testing, validation, and audit readiness for digital quality measurement, HEDIS, and associated clinical quality initiatives.

⛳️ Requirements

• Must possess authorization to work in the U.S. without the requirement for employment-based visa sponsorship, now or in the future.

• Bachelor's Degree in Nursing, a related field, or equivalent experience is mandatory.

• A minimum of 7 years of experience in quality management, quality improvement, or healthcare operations is required.

• Experience with digital quality measurement, HEDIS, ECDS, FHIR, healthcare interoperability, or similar quality transformation initiatives is highly desirable.

• Familiarity with audit readiness is essential.

• Capability to translate clinical requirements into operational and technological solutions is necessary.

• A Master's Degree is preferred.

• Certain states may necessitate a formal certification in quality improvement, risk management, or a related field.

• A current RN license in the state of practice is preferred.

• Certification as a Professional in Health Care Quality is preferred.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase plans available.

• Tuition reimbursement opportunities.

• Paid time off in addition to holidays.

• Flexible work arrangements including remote, hybrid, field, or office schedules.

• Additional incentive options may be included in the total compensation package.

• Equal opportunity employer dedicated to promoting diversity.