Director of Quality | Managed Care
Job Title: Director of Quality |Managed Care
Employer: MMS Group
Location: chicago, Illinois
Job Type: Full-Time
Career Level: Experienced
Experience: 5-10 years
Education Level: Bachelors Degree
Director, Quality – CHICAGO
Join a talented leadership team as this international organization continues to grow and thrive.
Director will drive process improvement activities to provide more efficient and streamlined workflow.
- Responsible for leading and collaborating with others on NCQA and HEDIS.
- Responsible for quality improvement aspects of risk adjustment processes for all products
- Collaborate with Medicare STARS team to improve overall STARS ratings for Medicare products (including HEDIS, CAHPS, HOS)
- Oversee provider satisfaction surveys and implement action plans for improvements
- Research and incorporate best practices into operations
- Organize and control activities, methods, and procedures to achieve business objectives
- Review and implement new technological tools and processes
- Fosters team concept with internal and external constituencies
- Present results of improvement efforts and ongoing performance measures to senior management
- Formulate and establish policies, operating procedures, and goals in compliance with internal and external guidelines
- Bachelor’s degree but RN not required (Masters’ degree preferred)
- 7+ years of quality management, quality improvement or healthcare operations experience..
- Certified Professional in Health Care Quality preferred
- STRONG experience in Medicare/Medicaid/HEDIS/NCQA/STARS
- Strong Medicare / Medicaid background