Quality Improvement Director
6 days ago
**Job Title:** Quality Improvement Director
**Job Summary:** We are seeking a highly skilled Quality Improvement Director to lead our Quality Improvement program, ensuring compliance with accreditation, regulatory, and program requirements. The successful candidate will oversee project teams, provide guidance to subject matter experts, and manage committees to ensure programs meet standards.
Key Responsibilities:- Program Management: Oversee the Quality Improvement program, including the oversight of staff and necessary resources required to design and implement programs related to compliance with accreditation, regulatory, and program requirements.
- Committee Management: Manage committees, delegated entities, and subgroups to comply with accreditation standards and regulations.
- Staff Management: Select, develop, and manage staff. Provide coaching, feedback, and performance evaluations to ensure effective business practices and departmental goals are met.
- Issue Resolution: Identify and actively resolve issues that hinder program efficiencies or outcomes.
- Business Function Assessment: Manage and direct ongoing assessment of business functions for numerous departments within the scope of NCQA standards to support high-quality performance and ensure successful NCQA re-accreditation.
- Collaboration and Communication: Create and foster working relationships with internal and external parties that facilitate accreditation/regulatory audit and QI program success.
- Delegation Oversight: Oversee accredited delegation relationships and quality improvement activities with HMSA's strategic partners and with key departments.
- Complaints and Grievances: Direct the provider service quality/quality of care complaint process related to the quality of delivery of healthcare services to ensure resolution and an integrated process with other HMSA departments and lines of business.
- Model of Care Effectiveness: Manage staff charged with the oversight and maintenance of the Medicare Advantage Dual Special Needs Population (DSNP) Model of Care (MOC) Effectiveness Measures.
- Administrative Functions: Prepare annual unit plan and budget, monitor regularly, and take appropriate action to manage actual expenses against budgeted expenses.
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