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Director of Quality

2 months ago

Coral Gables, United States Ajulia Executive Search Full time

Position Overview:

The Quality Director role involves overseeing and enhancing the Quality Improvement Program (QIP), including HEDIS and STARS metrics. Responsible for developing and monitoring quality assurance initiatives, ensuring compliance with regulatory standards, and leading the Quality Improvement Department.


Key Responsibilities:

  • The Quality Director must ensure compliance with State, CMS, AHCA, and other regulatory bodies.
  • Develop and enforce policies for regulatory compliance, including HIPAA.
  • Lead and develop the Quality Improvement team.
  • Oversee the Quality of Care/Service Grievance Department.
  • The Quality Director must identify and address potential quality and compliance issues.
  • Serve on various committees and provide quarterly reports to relevant bodies.
  • Manage hiring and training for the department.
  • Monitor and implement corrective action plans as needed.
  • The Quality Director must collaborate with medical staff and administration, participate in committees.
  • Stay updated on Medicare Advantage guidelines and regulatory changes.
  • Improve care and service through quality improvement projects.
  • Educate stakeholders on quality goals and practices.
  • The Quality Director must prepare the annual Quality Improvement Work Plan, evaluations, and reports.
  • Maintain communication with state and federal officials on quality matters.


Qualifications:

  • The Quality Director must hold a master’s degree in health administration or related field preferred, or BS/BA
  • Must have 10+ years in managed care focusing on HEDIS/STARS.
  • 5+ years in a supervisory role with experience in hiring, performance evaluations, and team management.
  • The Quality Director must have experience in Medicare Advantage and SNPs, with knowledge of CMS regulations.
  • Proficiency in HEDIS, Medicare Stars, and related quality measures.
  • Experience in coordinating HEDIS projects and communicating with stakeholders.
  • The Quality Director must have strong leadership, strategic planning, and team-building skills.


BENEFITS:


● Medical Insurance

● Dental Insurance

● Vision Insurance

● Direct Hire

● Paid time off

● $150k - $200k/annum depending on experience

● Bonus



Ask for: Amrita Mukherjee