Director Quality Improvement

Profile

Description

The Director, QOCA Strategy - serves as the strategic leader in resource utilization; budget and MER oversight; vendor oversight; and for clinician and non-clinician flex associates and off-shore vendor associates assignments.

Responsibilities

Responsibilities

The Director, QOCA Strategy works with QOCA leadership team; Corporate Finance; Senior leaders of Medicare, Medicaid and Commercial products; HCO leadership; Vendor Procurement; and other key internal, and potentially external, stakeholders to drive line of business performance optimization inclusive of activities spanning decisions required for day-to-day operations to strategic planning and fostering key relationships with business stakeholders. Decisions are typically related to allocation of resources for the implementation of new/updated programs, implementing strategic plans, driving goals and objectives, and improving performance. Provides input to inform and influence business strategy.


Leadership and oversite of assignments of 50 associates, 45 VSP associates and 75 offshore (Manilla) associates.
Manage annual QOCA budget of $26M and MER allocation
Collaborate with internal teams in development of senior leadership reports of QOCA activities/scorecards for all LOBs
Vendor contract oversight to assure service level agreements are being met and are being reviewing regularly. Will facilitate contract amendments.
Contribute to QOCA strategy formulation/goal setting to meet business and financial goals
Manage monthly resource and budget updates for QOCA leadership
Determine impacts of new business and policy changes on resource needs
Keep finance up to date of any anticipated changes, additions, deletions to budget spend


Required Qualifications


Bachelor's Degree in Nursing, Business Administration, Health Care Administration, or a related field
5 or more years of management experience
5 or more years of managed care experience or equivalent experience
Excellent verbal, written and presentation skills with a demonstrated ability to compose correspondence and content materials
Strong prioritization skills
Strong analytical skills
Brings an organized and attention to detail approach
Proven track record of successful team leadership and development
Excellent interpersonal, negotiation and communication skills and proven ability to work effectively with all organizational levels
Ability to multi-task and effectively manage competing priorities
Experience with organizational change management
Demonstrates commitment to diversity and inclusion
Must be passionate about contributing to an organization focused on continuously improving consumer experiences and financial performance
Ability to strategize and solve problems


Preferred Qualifications


Master's degree in Business or other related field
Previous experience with budget management and productivity analysis
Six Sigma and/or Lean Certified


Additional Information

WAH allowed

Scheduled Weekly Hours

40

Company info

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