Director Market Quality Improvement(Ohio Residency Required)
Core
Directs activities to achieve defined quality goals and outcomes, ensuring market compliance with NCQA accreditation, state requirements, and quality performance standards.
Role type
Director, Market Quality Improvement
Builds
Quality Improvement Programs, QAPI processes, and performance improvement projects for assigned markets.
Domain
Healthcare / Managed Care / Medicaid
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Strategic leadership, data analysis and trending, root cause analysis, regulatory compliance management, stakeholder collaboration, budgeting and financial forecasting, program development and implementation
Preferred skills
Masters in Nursing, Business, or Management
Technologies
Microsoft Word, Excel, PowerPoint
Responsibilities
Execute Quality Improvement programs ensuring NCQA and state compliance; develop and monitor annual Quality Improvement Plans and QAPI processes; analyze member risk and quality data to improve performance; oversee workgroups and committees to improve quality measure outcomes; respond to audit inquiries and develop corrective action plans; represent the organization to state-based committees and accreditation authorities; assist in strategic planning and staff workload prioritization
Seniority
Director, strategic leadership & execution
