Chief Quality & Accreditation Officer

Florida Blue Group; Jacksonville (FL); On-site; USD 260,000 - 400,000; Full time

Benefits offered by this job

Comprehensive benefits

Retirement Savings Plan with employer

Paid time off

Well-being days

Job summary

Florida Blue seeks a seasoned executive to lead Quality & Accreditation across Medicare and Commercial. This role drives HEDIS performance, NCQA/URAC accreditation, and enterprise quality programs, unifying siloed functions into a single operating model.

You will oversee vendor ecosystems, data integrity, and reporting, collaborating with executive leadership to align on shared clinical priorities. The ideal candidate has 10+ years in health plan quality with a proven track record of improving

Qualifications

• 10+ years leadership in health plan quality, HEDIS, and accreditation across Medicare and Commercial
• Bachelor’s degree in healthcare administration, public health, business or related field preferred
• Proven track record of improving HEDIS rates and NCQA/URAC outcomes
• Deep knowledge of HEDIS specs and accreditation standards
• Experience leading large cross-functional teams and vendor ecosystems
• Strong financial acumen, including forecasting and ROI analysis

Responsibilities

• Build a unified quality operating model across Medicare and Commercial.
• Establish enterprise governance for clinical documentation integrity.
• Own enterprise HEDIS performance and accreditation status.
• Oversee HEDIS operations, data collection, and provider documentation improvement.
• Lead development of intervention playbooks for each HEDIS measure.
• Direct enterprise clinical quality programs and provider performance initiatives.
• Align quality initiatives with care management and population health.
• Partner with C-suite and leaders to coordinate enterprise-wide quality initiatives.
• Own accreditation strategy and execution for NCQA/URAC and others.
• Lead survey readiness, documentation, and corrective action planning.
• Maintain evolving accreditation standards and renewal readiness.
• Manage vendor ecosystem for HEDIS data collection and abstracting.
• Consolidate vendors and establish unified SLAs and KPIs.
• Ensure data quality and timely integration across systems.
• Develop unified reporting architecture for HEDIS and accreditation.
• Ensure regulatory compliance and audit readiness.

Skills

Leadership

HEDIS & Accreditation

Vendor management

Cross-functional leadership

Financial acumen

Education

Bachelor’s degree in healthcare administration/public health/business

Master’s degree preferred

Tools

HEDIS data systems

Data analytics tools

Job description

Florida Blue seeks a seasoned executive to lead Quality & Accreditation across Medicare and Commercial. This role drives HEDIS performance, NCQA/URAC accreditation, and enterprise quality programs, unifying siloed functions into a single operating model.

You will oversee vendor ecosystems, data integrity, and reporting, collaborating with executive leadership to align on shared clinical priorities. The ideal candidate has 10+ years in health plan quality with a proven track record of improving