Pennsylvania Licensed Quality Director
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Job Summary
To ensure the ongoing quality improvement of Long Term Services & Support (LTSS), the fully remote Pennsylvania Licensed Quality Director will oversee compliance with state regulations and accreditation standards, manage quality initiatives, and collaborate with senior executives to enhance clinical and financial outcomes.
Key responsibilities
- Oversee quality management for Long Term Services and Supports (LTSS) in Pennsylvania
- Ensure compliance with state regulations and accreditation standards, including NCQA and URAC
- Collaborate with stakeholders to develop strategies that improve HEDIS outcomes and maximize performance payouts
Required qualifications
- Bachelor's degree required
- Active unrestricted licensed Registered Nurse (RN) in Pennsylvania or healthcare quality certification (e.g., CPHQ)
- 1 to 3 years of experience in Medicaid
- 5 to 10 years of experience in a clinical setting
- 5 or more years of experience in managed care and leadership
Complete Job Description
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