Director of Quality Improvement

Location: San Diego, CA
Date Posted: 03-08-2018
Director of Quality Improvement - Health Plan
San Diego, CA
Director of Quality Improvement Job Summary:
  • The Director of Quality Improvement is responsible for strategically developing and coordinating Quality Improvement Program-related activities, objectives, and analysis within the health plan.
  • This includes oversight of the day-to-day operations of the quality management department.
  • The Director of QI provides ongoing maintenance and evaluation of systems and strategies to support the improvement of quality management accreditation through promoting and supporting innovation.
  • Director of Quality Improvement is Responsible for ensuring compliance and providing direction and guidance for National Committee for Quality Assurance (NCQA) accreditation.
  • In addition, the Director of QI is responsible for establishing and monitoring procedures for receiving, investigating and responding in writing to member and provider grievances and appeals involving the review of clinical information.
Director of Quality Improvement Background:
  • Registered Nurse (R.N.) license is preferred, but is NOT required.
  • Requires Bachelor degree in Nursing or related; Master’s in Business, Healthcare Administration, etc highly preferred.
  • 10 years progressive managerial and strategic leadership experience in Health Plans or other Managed Care Organizations, with a strong emphasis on NCQA accreditation.
  • At least 5 years experience in Quality Management/Quality Improvement in an HMO setting responsible for data and NCQA.
  • Established experience with attaining National Committee for Quality Assurance (NCQA) accreditation.
  • Requires at least 1 year prior experience with the state Medicaid program, Medi-Cal
  • Strong computer skills, at a minimum, proficient in data analysis and MS Access, Word, PowerPoint, and Excel.
  • Possess planning, organizing, conflict resolution, negotiating and interpersonal skills.

Prashant Patel
Account Manager
CareNational Healthcare Services
480.646.3275 (CALL – TEXT – FAX)
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