Details.
Reporting to the CMO, the Director of Quality designs, implements, monitors, and continuously improves the Quality Management Program. Responsibilities include overseeing the annual Quality Management Program Description, Work Plan, and Annual Evaluation; coordinating Quality Management Committee activities; leading HEDIS, CAHPS, HOS, and STAR Rating improvement initiatives; ensuring CMS, accreditation, and state requirements are met; preparing for audits and surveys; engaging providers and delegated entities; developing education and training programs; and collaborating with Compliance, Utilization Management, Risk Adjustment, Member Services, and Population Health. A bachelor's degree or equivalent in nursing, healthcare administration, public health, or a related field is required, along with at least 5 years of healthcare quality management experience, including 2 years in Medicare Advantage or managed care. Strong knowledge of CMS Part C and D regulations, STAR Ratings, HEDIS, CAHPS, and NCQA or URAC standards is required, as are analytical, communication, project management, organizational, and collaboration skills. Salary is $165,000 to $205,000 per year. eternalHealth is an Equal Opportunity Employer committed to inclusive, discrimination-free hiring practices.