Director, Quality Operations — HEDIS & Stars Leader

Zing Health, Inc.; Northern (KY); Hybrid; USD 120,000 - 170,000; Full time

Benefits offered by this job

Competitive salary

Medical, Dental, Vision

Employer-Paid Life Insurance

Paid Maternal Leave

Paid Paternal Leave

401(K) match up to 4%

Paid-Time-Off

Employee Assistance Programs

Spouse Insurance

Pet Insurance

Critical Illness coverage

ID Protection

Job summary

Zing Health is a tech-enabled insurance company focused on Medicare Advantage for 65+. The Director, Quality Operations leads HEDIS, Stars initiatives, and audits to ensure compliance with NCQA and federal/state standards.

You will educate providers, coordinate quality initiatives, and drive measurable improvements in care and member experience. The role requires strategic quality leadership across enterprise programs, collaboration with providers and networks, and management of documentation,

Qualifications

• HEDIS reporting experience or Stars related quality improvement.
• Experience aligning data sources to HEDIS specifications.
• Experience coordinating NCQA submissions and documentation.
• Ability to deliver education to providers on HEDIS measures and coding.

Responsibilities

• Acts as subject matter expert for HEDIS measures, audits, and submissions.
• Develops interventions related to Stars performance including HEDIS and pharmacy measures.
• Implements quality strategies and provider/member interventions for outcomes.
• Administers enterprise quality programs, audits, and accreditation activities.
• Ensures compliance with federal and state regulations impacting the plan.
• Develops and monitors HEDIS data files and abstraction processes.
• Leads documentation and NCQA submissions for Health Plan and SNPs.
• Educates providers and IPAs on HEDIS documentation and coding requirements.
• Collaborates with Provider Network to improve quality, risk adjustment, and operations.
• Develops Quality Management Plan and monitors progress to QM Committee.

Skills

HEDIS experience

Medicare Stars

CAHPS

Data analysis

Quality improvement

HEDIS coding guidance

Education

Bachelor’s degree in Healthcare/Clinical/Public Health

Three years HEDIS reporting or five years management

Master’s degree (preferred)

Registered Nurse licensure (preferred)

Tools

Excel

Word

Outlook

PowerPoint

Job description

Zing Health is a tech-enabled insurance company focused on Medicare Advantage for 65+. The Director, Quality Operations leads HEDIS, Stars initiatives, and audits to ensure compliance with NCQA and federal/state standards.

You will educate providers, coordinate quality initiatives, and drive measurable improvements in care and member experience. The role requires strategic quality leadership across enterprise programs, collaboration with providers and networks, and management of documentation,