Director, Statewide Quality California Medicaid

Director, Statewide Quality California Medicaid

Full-time

Director, Statewide Quality California MedicaidThousand Oaks, California

Experience: 10-15 years

Degree: Bachelor's

Relocation: Yes

Bonus: Yes

Occasional Travel: Yes

Job Description

This is a statewide position that will oversee all quality and NCQA activities for the CA Medicaid Business, reporting to the Chief Medical Officer. Primary duties may include, but are not limited to:

Provides leadership for implementation of The Quality Management Program for the assigned California Health Plan.

Establishes annual goals and objectives.

Promotes understanding, communication, and coordination of the Clinical Quality Management Program.

Oversees Quality Management (QM) Scorecard reporting.

Provides leadership for the development, implementation, and evaluation of Clinical Quality improvement action plans.

Provides leadership for the member/provider satisfaction survey process.

Oversees Health Employer Data Information Sets (HEDIS) reporting and the development of action plans to achieve target improvement goals.

Supports the Health Plans External Quality Review Organization (EQRO) state audit processes.

Participates in the Quality Improvement Council (QIC).

Supports compliance with National Committee for Quality Assurance (NCQA) standards or other accrediting bodies.

Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Qualifications

Requires a BA/BS.

10 years of 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.

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