Director of Clinical Operations and Quality

1 day ago


Wheeling, West Virginia, United States The Health Plan of West Virginia Inc Full time

The Health Plan of West Virginia Inc invites applications for the position of Director of Clinical Operations and Quality. This role requires a seasoned medical professional with a proven track record in managed care and quality improvement.

About the Role

The estimated annual salary for this position is $225,000, plus benefits. We are looking for an individual who can work collaboratively with cross-functional teams to drive excellence in healthcare services.

Responsibilities
  1. Develop and Implement Programs: Lead the development and implementation of Utilization Management and Quality Management programs, including preparing for audits and information requests from regulatory entities.
  2. Clinical Quality Issues: Monitor, evaluate, and validate clinical quality issues, referring them to internal staff, committees, or institutional regulatory bodies.
  3. Provider Education and Intervention: Collaborate with Network Development staff to develop effective provider education/intervention programs, including input into provider training and education programs.
  4. Quality Improvement Mechanism: Organize a continuous quality improvement mechanism for The Health Plan, identifying specific clinical goals and objectives for focus or priority.


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