Director, Statewide Quality California Medicaid

Director, Statewide Quality California Medicaid

• Full-time
• Position: Director, Statewide Quality California Medicaid
• Experience: 10-15 years
• Education: Bachelor's Degree
• Relocation assistance available
• Bonus eligible
• Occasional travel required

Job Description

This is a statewide position overseeing all quality and NCQA activities for the California Medicaid Business, reporting to the Chief Medical Officer. Primary responsibilities include, but are not limited to:

• Providing leadership for the implementation of the Quality Management Program for the California Health Plan.
• Establishing annual goals and objectives.
• Promoting understanding, communication, and coordination of the Clinical Quality Management Program.
• Overseeing Quality Management (QM) Scorecard reporting.
• Leading the development, implementation, and evaluation of Clinical Quality improvement action plans.
• Managing the member/provider satisfaction survey process.
• Overseeing HEDIS reporting and developing action plans to meet improvement targets.
• Supporting external audit processes with the Health Plans External Quality Review Organization (EQRO).
• Participating in the Quality Improvement Council (QIC).
• Ensuring compliance with NCQA standards or other accrediting bodies.
• Hiring, training, coaching, counseling, and evaluating direct reports.

Qualifications

• Bachelor's Degree required.
• Minimum of 10 years' experience in quality management.
• HEDIS and health plan experience preferred.
• RN, MBA, MPH, or additional Quality certifications preferred.

All your information will be kept confidential according to EEO guidelines.

Direct Staffing Inc