VP, Health Plan, Quality Management

3 weeks ago


New York, New York, United States VNS Health Full time
Job Summary

As a key member of the VNS Health team, the VP, Health Plan, Quality will be responsible for leading the development and implementation of quality programs and initiatives to ensure the highest standards of care and service for our members.

The ideal candidate will have a strong background in quality improvement, with a proven track record of leading successful initiatives and improving performance metrics. They will be responsible for monitoring and analyzing Medicare Stars and quality performance metrics, identifying areas for improvement, and developing and implementing strategic plans to address these gaps.

The VP, Health Plan, Quality will also be responsible for overseeing the performance of Health Plans Quality Programs, emphasizing continuous quality improvement and member satisfaction. They will work closely with cross-functional teams, including Care Management, Call Center, Pharmacy Services, and Provider Network, to ensure alignment with quality objectives and regulatory requirements.

The successful candidate will have excellent analytical and problem-solving skills, with the ability to interpret complex data and translate it into actionable insights. They will also have strong communication and presentation skills, with the ability to lead and motivate a diverse team of professionals.

Key Responsibilities:

  • Develop and implement comprehensive strategic plans for Health Plans Quality Programs
  • Monitor and analyze Medicare Stars and quality performance metrics
  • Identify areas for improvement and develop strategic plans to address these gaps
  • Oversee the performance of Health Plans Quality Programs
  • Work closely with cross-functional teams to ensure alignment with quality objectives and regulatory requirements

Requirements:

  • Bachelor's Degree in nursing, health care, or equivalent work experience required
  • Master's Degree in nursing, health care, or equivalent work experience preferred
  • Minimum of eight (8) years of progressive leadership in quality improvement with specific managed care experience
  • Extensive knowledge of managed care regulations and quality standards and improvement methodologies
  • Proven track record of leading successful quality improvement initiatives and improving performance metrics


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