Strategic Quality Ops Director - HEDIS & Stars

Zing Health; Illinois; On-site; USD 120,000 - 170,000; Full time

Benefits offered by this job

Medical, Dental, and Vision

Employer-Paid Life Insurance

Paid Maternal Leave

Paid Paternal Leave

401(K) match up to 4%

Paid Time Off

Employee Assistance Programs

Supplemental benefits program

Job summary

Zing Health in Illinois is seeking a Director, Quality Operations to lead HEDIS programs, audits, and NCQA submissions. This role will guide quality improvement initiatives, provider education, and Stars performance strategies to ensure compliance with state and federal standards.

The ideal candidate has advanced experience in HEDIS reporting, data integration, and QA processes, with strong leadership and communication skills to collaborate across the care delivery network.

Qualifications

• HEDIS reporting experience required.
• Experience with Stars and NCQA standards.
• Ability to educate providers on HEDIS measures.
• Strong data analysis and QA processes.

Responsibilities

• Leads HEDIS measures audits and submissions.
• Develops interventions to improve Stars performance.
• Manages provider, member, and community interventions.
• Oversees QA and accreditation strategies.
• Collaborates to ensure compliance with federal and state regulations.
• Monitors NCQA submissions.
• Educates providers on HEDIS coding.
• Improves provider performance in Quality, Risk Adjustment and Operations.
• Develops annual Quality Management Program and Work Plan.
• Facilitates QM committee meetings.
• Performs other related duties.

Skills

HEDIS experience

Medicare Stars

Data analysis

Quality improvement

NCQA guidelines

Clinical data integration

Education

Bachelor’s degree in Healthcare, Clinical Profession, or Public Health

Master’s degree preferred

Registered Nurse Licensure

Tools

Microsoft Excel

Microsoft Word

Microsoft Outlook

Microsoft PowerPoint

Job description

Zing Health in Illinois is seeking a Director, Quality Operations to lead HEDIS programs, audits, and NCQA submissions. This role will guide quality improvement initiatives, provider education, and Stars performance strategies to ensure compliance with state and federal standards.

The ideal candidate has advanced experience in HEDIS reporting, data integration, and QA processes, with strong leadership and communication skills to collaborate across the care delivery network.