Quality Improvement Director

Job Summary

Leading the digital quality measurement strategy, the full-time remote Quality Improvement Director will manage process improvement activities, enhance clinical quality data workflows, and collaborate on NCQA Accreditation and HEDIS performance initiatives.

Key responsibilities:

• Oversee quality improvement aspects of risk adjustment processes for all products
• Collaborate with the Medicare STARS team to enhance overall STARS ratings for Medicare products
• Lead the strategy and audit readiness for digital quality measurement and related clinical quality initiatives

Required qualifications:

• Bachelor's Degree in Nursing or a related field; Master's Degree preferred
• 7+ years of experience in quality management, quality improvement, or healthcare operations
• Experience with digital quality measurement, HEDIS, and healthcare interoperability preferred
• Current RN license or certification in quality improvement/risk management preferred
• Knowledge of audit readiness and ability to translate clinical requirements into operational solutions