Director I Gbd Quality Management
Current• Provide oversight and leadership for day-to-day operations for the Quality Management Department to include Performance Improvement, Clinical Compliance, NCQA, VBP, Performance Measures validation, Member Experience, and Reporting.• Supervise, develop, and evaluate QM Department staff, including Clinical Quality Program Managers, Specialists, Administrators, and Interns.• Collaborate across business segments to attain or maintain the Health Plan’s compliance with accreditation standards and contractual requirements as they apply to Quality.• Ensure compliance with state contract, federal regulations, and NCQA standards.• Develop and implement programs and processes to achieve HEDIS and state value-based purchasing program requirements, with a focus on Health Equity and Population Health.• Establish and implement initiatives to achieve maximum results from member satisfaction and state provider satisfaction survey initiatives.• Effectively use data analysis to identify trends and population risks to drive performance improvement, monitor patient safety, and effectiveness of care.
