Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
Director of Quality - Remote in the California market
Job Description Summary
Responsible for all aspects of the quality program for a business unit within a Strategic Business Unit (SBU) including strategic planning, program development and leadership, and staffing.
Serves as a member of the management team in designing, implementing, and monitoring quality operations with well defined processes and uses performance measurement as the foundation for quality and process improvements.
Responsible for performance measurements and analytics, customer reporting, client delegation activities, policies and procedures, quality of care concerns tracking, accreditation preparation, coordination of satisfaction surveys, performance guarantee tracking, integration of quality improvement processes and compliance oversight.
Represents the quality program to customers and regulatory entities on quality operations and performance achievement.
Job Description
- Directs and supervises proactively the quality department and projects to meet unit goals for the quality program, including the monitoring cost effectiveness, policies, procedures, activities, to meet multiple contractual requirements, external accreditation, and state and federal regulations.
- Ensures that quality improvement studies and activities are conducted with appropriate feedback from customer organizations, assigned departments, and member and provider input.
- In consultation with assigned business unit leadership, sets priorities for improving operations based on data from performance indicators, delegation audits, and quality improvement processes.
- Serves as liaison with department managers to ensure that needs are met for internal and external reporting and analytics and the development of decision support tools.
- Oversees internal and external audit procedures to meet customer requirements, accreditation standards and goals of the assigned business unit.
- Serves as co-chair of the unit's Quality Improvement Committee and provides oversight of committee documentation (as applicable).
- Assists Learning Department in development and presentation of CQI and compliance training programs for staff and customers.
Responsibilities
- Knowledge of NCQA and URAC standards as applicable.
- Knowledge of HEDIS / STAR as applicable.
- Knowledge of statistical analysis procedures and software.
- 7+ years of experience in healthcare.
- 5+ years of experience in quality.
- 3+ years of experience in management / leadership.
- Knowledge of quality improvement processes, performance measurement, accreditation standards, measurement tools, CQI tools and data reporting applications.
- Knowledge of CQI training and QIA methodology.
- Demonstrated management and leadership skills.
- Expertise in data management software including spreadsheet development and use.
- Must be skilled at mastering new areas of content and operations.
- Excellent written and verbal communication skills required.
Work Experience
Work Experience - Required :
Healthcare, Management / Leadership, Quality
Work Experience - Preferred :
Education
Education - Required :
Bachelors, Bachelors - Healthcare
Education - Preferred :
Masters - Healthcare
Certifications
Certifications - Required :
Certifications - Preferred :
LCSW - Licensed Clinical Social Worker - Care Mgmt - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt - Care Mgmt, LSSBB - Lean Six Sigma Black Belt Certification - Enterprise - Enterprise, LSSGB - Lean Six Sigma Green Belt Certification - Enterprise - Enterprise
Potential pay for this position ranges from $97,760.00 - $166,180.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https : / / www.primetherapeutics.
com / careers / benefits / ) and click on the Benefits at a glance button for more detail.
Prime Therapeutics LLC is an Equal Opportunity Employer and a Tobacco-free workplace . We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected class under federal, state, or local law.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position;
and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures .
Positions will be posted for a minimum of five consecutive workdays.
Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry.
Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.
If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.
Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.
If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.
866.469.1257 or email [email protected].
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