Offer summary

Qualifications:

Bachelor of Science degree in healthcare or equivalent experience required., Master’s degree in healthcare or business preferred., Minimum of five years of leadership and management experience in managed care required., Minimum of five years of quality improvement experience in healthcare or managed care required..

Key responsabilities:

Develop and execute quality strategy across multiple markets to meet accreditation and regulatory standards.

Oversee Quality Committee performance and ensure alignment with regulatory standards.

Monitor and report on key quality and performance indicators and implement improvement initiatives.

Manage relationships with state departments and drive a culture of continuous quality improvement across the organization.

Job description

Job Summary:

The Associate Vice President, Quality Operations is responsible for driving quality performance results across multiple markets. They will develop and lead quality strategy and ensure effective execution of both market and enterprise quality programs to achieve enterprise quality goals.

Essential Functions:

Develop and execute on quality strategy for multiple markets, working collaboratively with market and enterprise senior leaders, to achieve accreditation, state and other regulatory quality performance standards and enterprise quality goals
Oversee Quality Committee performance ensuring necessary participation, effectiveness and alignment of Committee activities and outputs with regulatory standards
Develop and implement standardized quality improvement initiatives, programs, tools and innovations to improve market performance and delivery of high-quality care and services across the Enterprise
Monitor effectiveness of quality programs and interventions, utilizing quality tools and continuous quality improvement framework
Monitor and report out on key quality and performance indicators and associated interventions
Identify and mitigate quality performance deficits in Markets and lead collaboratively across teams to facilitate appropriate engagement of enterprise, operational and market resources
Influence quality outcomes through the development, implementation and monitoring of remediation strategies to improve HEDIS, NCQA and Star program results
Manage relationships with state departments and quality organizations as needed
Drive a culture of continuous quality improvement across the organization
Collaborate in the development, implementation, support and evaluation of provider performance programs including value-based agreements and data/programs supporting provider performance management
Lead the alignment and collaboration between Market/Product teams and Enterprise activities to ensure timely and accurate responsiveness and resolution to any systems, regulatory, or compliance issues related to quality
Other job duties as requested

Education and Experience:

Bachelor of Science degree in healthcare field or equivalent years of relevant work experience is required
Master’s degree in healthcare or business is preferred
Minimum of five (5) years of leadership and management experience in managed care setting is required
Minimum of five (5) years of quality improvement in the healthcare or managed care industry is required

Competencies, Knowledge and Skills:

Intermediate proficiency level with Microsoft Office
Knowledge of full range of product requirements from regulatory, operations, and compliance
Critical listening and systematic thinking skills
Ability to attract, manage and develop team members through inspirational leadership
Ability to maintain confidentiality and act in the company’s best interest
Strong oral, written, and interpersonal communication skills
Ability to act with diplomacy and sensitivity to cultural diversity
Responsive to a changing environment
Health Plan Financial & Administration Management Acumen
Strategic management skills
Conflict resolution skills
Planning, problem identification and resolution skills

Licensure and Certification:

Clinical licensure is preferred
Certified Professional in Healthcare Quality (CPHQ) preferred
To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process

Working Conditions:

General office environment; may be required to sit or stand for extended periods of time
This role may require up to 20% travel based on the needs of the department

Compensation range $150,000-$300,000. CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies