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Dir Quality Program Management
Dir Quality Program ManagementCambia Health Solutions • Portland, Texas, USA
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Dir Quality Program Management

Dir Quality Program Management

Cambia Health Solutions • Portland, Texas, USA
[job_card.30_days_ago]
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  • [job_card.full_time]
[job_card.job_description]

Director Quality Program Management

Hybrid in Oregon Washington Idaho or Utah

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.

Who We Are Looking For :

Every day Cambias dedicated team is living our mission to make health care easier and lives better. As a member of the Quality team our Director Quality Program Management provides leadership for the development implementation and management of clinical quality program management functions across all Cambia plans (includes quality outcomes quality improvement initiatives HEDIS accreditation delegation oversight and compliance functions) all in service of creating a person-focused health care experience.

As a people leader you are willing to learn and grow understanding that leadership is a craft that is continuously honed as you support your team and the lives that depend upon us.

Do you have a passion for improving healthcare quality Are you highly organized and process driven Then this role may be the perfect fit.

What You Bring to Cambia :

Qualifications :

  • Masters Degree in Healthcare Nursing Business or related field
  • 10 years of progressively responsible health care experience 5 years in Quality Management 5 years of management / leadership experience or equivalent combination of education and experience.

Skills and Attributes :

  • Demonstrates ability to lead high performing teams manage managers and direct vendors.
  • Strong communication and facilitation skills with all levels of the organization including the ability to resolve issues and build consensus among groups of diverse stakeholders.
  • Demonstrated ability to leverage AI tools and resources to drive efficiency and innovation within area of expertise
  • General business acumen including understanding of market dynamics financial / budget management data analysis and decision making.
  • Knowledge of health insurance industry trends and technology.
  • Knowledge of quality improvement theory research design and statistics in the healthcare setting.
  • Understanding of medical risk management.
  • Demonstrates ability to create advocate for and execute quality management programs that achieve desired outcomes targets and drive performance across internal teams the delivery system and / or external vendors.
  • Extensive knowledge of CMS and state regulatory requirements and demonstrated ability to manage compliant operations.
  • Health Plan Accreditation (NCQA or URAC) and HEDIS measurement and reporting experience strongly preferred.
  • Ability to decipher and interpret clinical data and deliver presentations to various internal / external audiences related to clinical outcomes.

    • What You Will Do at Cambia :

  • Provides leadership in developing implementing and communicating short and long-range plans goals and objectives for the Quality Management function. Aligns team goals with the organizations vision and strategy.
  • Manages the organization by ensuring clear performance expectations along with appropriate skills sets.
  • Fosters an effective work environment and ensures employees receive recognition feedback and development. Participates in organizational talent management and succession planning.
  • Determines appropriate staffing levels and resource needs creates and manages department and / or project budget allocates resources and approves expenditures.
  • Ensures quality management programs achieve desired outcomes and meet federal and state regulations accreditation standards quality metrics client requirements and evolving models of care (e.g. accountable care organizations patient centered homes).
  • Leads multi-functional team to assure compliance with accreditation standards.
  • Ensures policies and procedures are updated timely as regulatory guidance changes and communicates / ensures necessary changes are implemented within impacted departments.
  • Oversees regulatory and contract compliance within the Quality Utilization Management and Care Management functions.
  • Provides leadership in preparation for regulatory audits and accrediting surveys.
  • Collaborates with Medical Directors Health Informatics Provider Services and other departments as needed to collect analyze and report on effectiveness of programs and address quality of care issues.
  • Leads identification and implementation of quality improvement and population health programs that improve performance.
  • Ensures education and training for leadership and staff and business associates as to the quality management plan and their respective responsibilities.
  • Represents the organization in a variety of external forums focused on quality improvement.
  • You bring unique value to our community of 200 leaders running our company. By actively engaging with your peers and inspiring your teams you play an essential role in making health care easier and lives better.

    • The expected hiring range for a Director Quality Program Managementis $00 depending on skills experience education and training; relevant licensure / certifications; and performance history. The bonus target for this position is 25%. The current full salary range for this role is $00.

    About Cambia

    Working at Cambia means being part of a purpose-driven award-winning culture built on trust and innovation anchored in our 100 year history. Our caring and supportive colleagues are some of the best and brightest in the industry innovating together toward sustainable person-focused health care. Whether were helping members lending a hand to a colleague or volunteering in our communities our compassion empathy and team spirit always shine through.

    Why Join the Cambia Team

    At Cambia you can :

  • Work alongside diverse teams building cutting-edge solutions to transform health care.
  • Earn a competitive salary and enjoy generous benefits while doing work that changes lives.
  • Grow your career with a company committed to helping you succeed.
  • Give back to your community by participating in Cambia-supported outreach programs.
  • Connect with colleagues who share similar interests and backgrounds through our employee resource groups.

    • We believe a career at Cambia is more than just a paycheck and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match bonus opportunities and more.

    In exchange for helping members live healthy lives we offer benefits that empower you to do the same. Just a few highlights include :

  • Medical dental and vision coverage for employees and their eligible family members including mental health benefits.
  • Annual employer contribution to a health savings account.
  • Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
  • Market-leading retirement plan including a company match on employee 401(k) contributions with a potential discretionary contribution based on company performance (no vesting period).
  • Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
  • Award-winning wellness programs that reward you for participation.
  • Employee Assistance Fund for those in need.
  • Commute and parking benefits.

    • Learn more about our benefits.

    We are happy to offer work from home options for most of our roles. To take advantage of this flexible option we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.

    We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race color national origin religion age sex sexual orientation gender identity disability protected veteran status or any other status protected by law. A background check is required.

    If you need accommodation for any part of the application process because of a medical condition or disability please email . Information about how Cambia Health Solutions collects uses and discloses information is available in our .

    Key Skills

    Attorney At Law,Customer,Customer Support,Excel,Assembling

    Employment Type : Full-Time

    Experience : years

    Vacancy : 1

    Monthly Salary Salary : 152000 - 247000

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