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Dir Quality Program Management
Dir Quality Program ManagementWashington Staffing • Renton, WA, US
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Dir Quality Program Management

Dir Quality Program Management

Washington Staffing • Renton, WA, US
2 days ago
Job type
  • Full-time
Job description

Director Quality Program Management

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, Cambia's 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 :

Master's 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 organization's 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 quality management programs.
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    Program Management • Renton, WA, US

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