Director, Quality Improvement

The Director of Quality Improvement will lead the design and execution of quality improvement programs, crafting and driving annual process improvement projects, quality reporting, and compliance monitoring. Key duties include overseeing HEDIS, CAHPS, and Star ratings reporting, operating an NCQA compliant quality program, and ensuring compliance with state health and safety standards. Responsibilities also encompass implementing clinical and non-clinical quality improvement projects, enhancing quality measure performance through member and provider engagement, and utilizing analytics and business intelligence tools for issue identification and risk mitigation. The role involves analyzing KPIs and metrics, improving value-based reimbursement models, providing oversight for quality program documentation, and serving on governance and quality management committees.