Director, Quality Operations

cityblockhealth; United States; On-site; USD 125,000 - 165,000; Full time

Benefits offered by this job

Health insurance

Life insurance

Retirement benefits

Equity program

Paid time off

Job summary

Cityblock Health is seeking a Director of Quality Operations to ensure data integrity for contracted quality measures and to govern member information, ensuring accurate performance reflection across partners.

The role leads HEDIS programs, audits, and the third-party engine, partnering with clinical, operations, and market teams to drive enterprise-wide quality initiatives. A small team of managers and associates will be led.

Qualifications

• Master's-level education in a healthcare field (MHA, MBA, MPH) required.
• 7+ years in a healthcare setting with quality reporting and operations.
• Demonstrated HEDIS expertise and auditing experience.
• Proficiency in Excel and Google Sheets; coding languages a plus.
• Experience with HEDIS engines.

Responsibilities

• Serve as HEDIS subject matter expert with deep knowledge of measures, data sources, and reporting requirements.
• Lead HEDIS audit readiness and response, including documentation and response.
• Drive data completeness and accuracy across systems; close data gaps before submission to partners.
• Own management and optimization of Cityblock's third-party HEDIS engine and workflows.
• Maintain a complete view of member gaps in care with cross-team collaboration.
• Lead and develop a small team of Managers and Senior Associates.
• Identify root causes of data quality issues and train involved teams.
• Collaborate across clinical and non-clinical teams to support enterprise initiatives.

Skills

Excel

Google Sheets

Data manipulation

HEDIS expertise

Data quality improvement

HEDIS engines

Education

Master's degree in healthcare field

Tools

HEDIS engines

Job description

Job Description:

The Director, Quality Operations is a strategic and operational leader responsible for the accuracy, completeness, and integrity of the data that drives Cityblock's performance on contracted quality measures. This leader ensures we have the most complete picture of member gaps in care and that our data is validated before it is sent to partners, so our performance is accurately and fully reflected. The role also owns data governance for membership-related information and processes for Cityblock contracts.

Responsibilities

• Serve as Cityblock's HEDIS subject matter expert, with deep knowledge of HEDIS measure specifications, data sources, and reporting requirements.
• Lead Cityblock's HEDIS audit readiness and participation, including audit preparation, documentation, and response.
• Drive data completeness and accuracy across systems, identifying and closing data gaps so that performance is accurately reflected before data is submitted to partners.
• Own the management and ongoing optimization of Cityblock's third-party HEDIS engine, which ingests data and reports on our performance. This includes data inputs, validation of outputs, and engine configuration and workflows.
• Maintain a complete, accurate view of member gaps in care, partnering with market, clinical, and operations teams so that gap closure is supported by reliable data.
• Lead and develop a small team of Managers and Senior Associates
• Evaluate system and workflow processes to find and fix root causes of data quality issues, and provide training to the teams involved.
• Collaborate across clinical and non-clinical teams (operations, technology, compliance, finance) and with market teams to implement enterprise-wide initiatives that support contracted quality measure performance.

Requirements

• Master's-level education or work in a healthcare field (MHA, MBA, or MPH) required; clinical experience a plus.
• 7+ years of experience in a healthcare setting (provider, hospital, value-based care, consulting, or health plan) working with quality reporting and operations, alongside care teams.
• Demonstrated HEDIS expertise, including understanding of HEDIS data and hands-on experience going through HEDIS audits.
• Proficiency in Excel and Google Sheets for data manipulation. Experience with coding languages is a plus.
• Experience improving data completeness and accuracy to support quality performance reporting.
• Experience working with HEDIS engines

We take into account an individual's qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company's equity program, paid time off, including vacation and sick leave. The actual offer will be at the company's sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location.

The expected salary range for this position is:
$125,000.00 - $165,000.00 Annual

Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.