Director of Quality | Managed Care | RN
National Health Care MCO
Job Title: Director of Quality | Managed Care | RN
Employer: Fortune 500 MCO
Location: Charlotte, North Carolina
Job Type: Full-Time
Profession: Registered Nurse
Career Level: Director of Above
Experience: 5-10 years
Education Level: Bachelor’s Degree
Amazing opportunity to build a team here in NC. This growing healthcare enterprise offers exceptional analytic support and resources to ensure success.
Relocation assistance – rich benefit package
Director of Quality will 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
- Bachelor’s degree in Nursing, related clinical degree or equivalent experience
- 5-7 years of quality management, quality improvement or healthcare operations experience in a large healthcare corporation serving Medicaid beneficiaries
- Masters’ degree preferred.
License/Certificates: Current state’s RN license or LCSW required. Certified Professional in Health Care Quality (CPHQ) preferred.
About MMS Group:
MMS is a Managed Care executive search firm. We are Managed Care’s complete recruiting resource.