Director of Quality Improvement | Health Plan | RN

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Job Details:

Job Overview:
Job Title: Director of Quality Improvement | Health Plan | RN
Employer: Confidential – National Managed Care Health Plan
Location: St. Louis, Missouri
Job Type: Full-Time
Profession: Registered Nurse
Career Level: Experienced
Experience: 5-10 years
Education Level: Bachelor’s Degree
Travel: none

Job Description:

Director, Quality Improvement

Director will work closely with the VP across all product lines for the growing Missouri market

Exceptional growth- generous relocation

  • Lead and direct process improvement activities that provide more efficient and streamlined workflow.
  • Responsible for leading and collaborating with others on National Committee for Quality Assurance (NCQA)
  • Accreditation and/or Healthcare Effectiveness Data and Information Set (HEDIS) performance
  • 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 and 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

Job Requirements:

  • Bachelor’s degree in Nursing, related clinical degree or equivalent experience.
  • Masters’ degree preferred
  • 7+ years of quality management, quality improvement or healthcare operations experience..
  • Formal certification in quality improvement, risk management, or another parallel field is preferred.
  • RN license
  • Certified Professional in Health Care Quality preferred.


Click Here for Details and to Apply


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