Regional Director, Operations
Core
Lead execution of Risk Adjustment, Quality (HEDIS), and Cost of Care programs across multiple healthcare markets to ensure operational excellence and regulatory compliance.
Role type
Senior leadership operations director (healthcare)
Builds
Scalable operational processes, data pipelines, and reporting dashboards for healthcare quality and risk management
Domain
Healthcare operations / Risk Adjustment / Quality Management
Required skills
Risk Adjustment (BOI), HEDIS quality measures, operational strategy, budget management, workforce planning, vendor management, process improvement, data analytics, SQL, EMR systems, claims data integration
Preferred skills
Six Sigma, Lean certification, large-scale healthcare transformation leadership
Technologies
EMR systems, claims data, reporting tools, Microsoft Office (Excel, Word, PowerPoint), SQL
Responsibilities
Lead multi-market Risk Adjustment and Quality programs; Develop and maintain SOPs, SLAs, and RACI frameworks; Optimize pre-visit/post-visit coding and chart review workflows; Monitor KPIs and lead continuous improvement initiatives; Oversee operational budgets and resource allocation; Partner with IT/Data teams on technical requirements and automation; Manage regional capacity planning and workforce modeling; Travel 4–10 days/month to partner locations.
Seniority
Senior, hands-on IC with strategic oversight
