Nevada Licensed Health Quality Executive

Job Summary

Providing strategic leadership, the full-time salaried Nevada Licensed Health Quality Executive will oversee health plan risk and quality activities, ensuring alignment with corporate strategies while collaborating with regulatory agencies and leading local quality committees to improve health outcomes.

Key responsibilities

• Develops and implements evidence-based quality intervention strategies in collaboration with corporate teams, ensuring compliance with state and federal regulations
• Leads local execution of quality improvement activities, monitoring performance indicators and coordinating with state agencies on risk and quality matters
• Manages and develops a high-performance team, demonstrating accountability for achieving quality and departmental goals

Required qualifications

• At least 10 years of experience in quality improvement/compliance/HEDIS operations in a managed care setting
• Minimum of 5 years in management or leadership roles
• Advanced knowledge of quality metrics, performance standards, and risk adjustment
• Experience in implementing quality interventions and educating network providers on value-based initiatives
• Proficiency in data analysis, reporting, and project management