Regional Director, Quality Solutions (Remote)

Lensa; Atlanta (GA); Remote; USD 80,000 - 110,000; Full time

Job summary

An innovative firm is seeking a Regional Director for Quality Solutions to lead performance improvements and uphold quality standards in health plans. This remote role requires a seasoned professional with extensive experience in Medicaid and Medicare quality, who can effectively liaise between national and local teams. The ideal candidate will develop strategic initiatives, manage compliance, and drive quality improvements across various locations. This position offers an exciting opportunity to influence healthcare quality and make a significant impact on community health outcomes.

Qualifications

• 7-10 years of experience in Managed Care or health plan quality.
• Strong knowledge of quality standards and performance improvement.

Responsibilities

• Oversee performance improvement and ensure quality standards.
• Collaborate with leadership and facilitate staff training.
• Develop strategic roadmaps and manage performance status.

Skills

Medicaid expertise

Medicare knowledge

Quality improvement

Data acquisition

Leadership collaboration

Education

Bachelor's degree in a related field

Master's degree (preferred)

RN certification

Job description

Regional Director, Quality Solutions (Remote)

This role involves overseeing performance improvement and ensuring quality standards within regional health plans, acting as a liaison between national and local teams, and managing strategic initiatives and compliance requirements.

Key responsibilities include:

1. Serving as a subject matter expert in Medicaid, Medicare, and Marketplace quality and data acquisition functions.
2. Collaborating with leadership to facilitate understanding of requirements and staff training.
3. Developing strategic roadmaps and communicating them to stakeholders.
4. Managing performance status, risks, and performance gaps, and proposing interventions.
5. Monitoring external correction plans and supporting quality improvement activities.
6. Participating in national and regional meetings, preparing materials, and ensuring timely communication of key performance indicators.
7. Leading or influencing cross-functional teams across locations.

Qualifications include a Bachelor's degree in a related field, 7-10 years of experience in Managed Care or health plan quality, with a preference for a Master's degree and RN certification with a quality background.