Position Purpose: Develop and oversee quality improvement programs and strategies for the business unit. Assist in the development and application of the business unit's strategic mission and vision. Identify and champion the selection of process improvement activities across the enterprise.
Responsible for driving performance improvement for HEDIS, Stars, State Contract Quality & Pay for Performance/Withhold, Marketplace QRS and Medicare Quality metrics and processes and other quality improvement opportunities as needed.
Education/Experience: Bachelor's degree in healthcare or related clinical field. Master's in Business Administration preferred. 10+ years of healthcare operations experience including, quality and process improvement experience. Experience with NCQA accreditation preparation and auditing, including the analysis of HEDIS performance measures.
License/Certificates: Certified Professional in Health Care Quality (CPHQ). RN License preferred.