Director, Quality Improvement

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POST DATE 9/8/2016
END DATE 10/8/2016

Managed Care & Health Insurance Company Milwaukee, WI

Company
Managed Care & Health Insurance Company
Job Classification
Full Time
Company Ref #
29678131
AJE Ref #
576121936
Location
Milwaukee, WI
Experience
Mid-Career (2 - 15 years)
Job Type
Regular
Education
Bachelors Degree

JOB DESCRIPTION

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The selected candidate will be responsible for leading and collaborating with others on National Committee for Quality Assurance (NCQA).Accreditation and/or Healthcare Effectiveness Data and Information Set (HEDIS) performance. Seeking an experienced Director of Quality Improvement RN Manager to ead and direct process improvement activities that provide more efficient and streamlined workflow.Responsible for leading and collaborating with others on National Committee for Quality Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set (HEDIS) performanceResponsible for quality improvement aspects of risk adjustment processes for all productsCollaborate with Medicare STARS team to improve overall STARS ratings for Medicare products (including HEDIS, CAHPS, HOS)Oversee provider satisfaction surveys and implement action plans for improvementsResearch and incorporate best practices into operationsOrganize and control activities, methods, and procedures to achieve business objectivesReview and implement new technological tools and processes and fosters team concept with internal and external constituenciesPresent results of improvement efforts and ongoing performance measures to senior managementFormulate and establish policies, operating procedures, and goals in compliance with internal and external guidelinesQualifications:Bachelor's degree in Nursing, Master degree preferred. 7+ years of quality management, quality improvement or healthcare operations experienceLicense/Certificates: Certain states may require a formal certification in quality improvement, risk management, or another parallel field. Current state s RN license preferred. Certified Professional in Health Care Quality preferred.