Regional HEDIS ManagerPrimary Location: Richmond, VA
Additional Locations: VA-Richmond Apply
Accountable for health care quality projects and initiatives through direction setting and leadership. Assimilates information to proactively develop quality activities aligned with company strategies and values. Links the quality management activities to business goals. Proactively builds strong teams and business relationships, both internally and externally. Serves as a resource and subject matter expert (SME) on aspects of the quality program to develop and influence business strategies.
64817Fundamental Components: Makes business decisions based on the results of research and data analysis. Has responsibility for decision making regarding the design, development, and implementation strategy of quality improvement projects, and initiatives. Manage a QM functional department including development and oversight of performance metrics and application of HR policies and procedures. Forms and leads cross functional teams to assist business units in integrating quality into their strategic and operational plans. Evaluates and prioritizes recommendations for quality improvement to senior management and/or customers.
Partners with Network, Medicare Stars and across all segments in their efforts to acquire and retain customers, supporting quality presentations, education and requests for measurement information. Performs strategic analysis of business performance data to address departmental and organizational goals. In partnership with business owners supports design / development of new or enhanced products, programs, and services. Influences department business owners and leaders to reach solutions to meet the needs of providers, members, regulators and other customers while meeting departmental objectives.Translates knowledge of subject and business needs into clear strategic business plans. Serves as a technical, professional and/or business expert that may cross multiple business functions. Directs and oversees provider engagement outreach of their team. Background Experience:
- 6+ years progressive experience in operational quality management roles in the healthcare industry, regulatory environment and quality management.
- Demonstrated leadership ability/previous experience.
- Bachelor's degree, Nursing degree, or other comparable healthcare experience required
- Moderate amount of HEDIS / Medicare Stars knowledge
- Tuition Assistance
- Medical Benefits
- Dental Benefits
- Vision Benefits
- Wellness Rewards
- Positive Team Environment
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