Director, Quality Improvement
Core
Lead process improvement activities, NCQA/HEDIS accreditation, risk adjustment, and cultural competency initiatives to improve healthcare outcomes and reduce disparities.
Role type
Director, Quality Improvement (Healthcare Operations)
Builds
Improved operational workflows, accreditation status, risk-adjustment accuracy, and culturally competent care delivery.
Domain
Healthcare / Quality Management / Health Equity
Required skills
Quality management, process improvement, NCQA accreditation, HEDIS performance, risk adjustment, Medicare STARS, provider satisfaction surveys, policy formulation, stakeholder collaboration, cultural competency planning, budget management, KPI monitoring.
Preferred skills
Master's degree in Nursing or related field, RN license, Certified Professional in Health Care Quality (CPHQ), experience with non-traditional provider credentialing.
Technologies
Health equity dashboards, technological tools for process improvement.
Responsibilities
Lead NCQA/HEDIS accreditation efforts, oversee risk adjustment processes, collaborate on Medicare STARS ratings, manage provider satisfaction surveys, research and implement best practices, formulate policies and procedures, present performance measures to senior management, oversee cultural competency plans and assessments, manage outreach budgets for cultural programs.
Seniority
Director, strategic leadership with hands-on operational oversight
