- Oversee a team responsible for evaluating and developing quality improvement and population health programs and initiatives that lead to improvements in clinical quality outcomes, with attention to care disparities and social determinants of health.
- Work with the Enterprise Quality Reporting (EQR) team to identify line of business and regional variations in clinical quality measures and population health statistics to inform targeted solutions.
- Collaborate with EQR to design, deliver and communicate reporting tools to support quality improvement and accreditation efforts.
- Work with the quality, data science and analytics teams to measure the impact of existing quality programs, design and communicate initiatives that effectively target variations in healthcare measures.
- Collaborate with Quality Operations team to coordinate quality improvement outreach efforts and initiatives and that support Accreditation Governance strategy.
- Partner with EQ&A and Quality Improvement Committee Meetings around quality best practices.
- Develop, review, and sign off on relevant policies and procedures.
- Maintain regular communication with management regarding developments within areas of assigned responsibilities and perform special projects as required or requested.
- Maintain currency with HEDIS, Hospital and other quality data sets, accreditation standards and a knowledge of marketplace, products, health care initiatives, technology, etc.
- Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
- Support and/or provide cross coverage in support of additional functions to ensure seamless execution of divisional priorities.
- Maintain complete confidentiality of company business.
- Other duties as assigned.
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Quality Improvement Manager
1 week ago
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AURA STAFFING PARTNERS CHICAGO LLC Oak Park, United States**Hospital Quality Manager - Risk Management** · **Quality Manager - Risk Management** · **SUMMARY** · The Quality Manager plans, directs, and evaluates patient care; facilitates quality improvement efforts and regulatory requirements among the Medical Staff and Hospital departme ...
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Director - Quality Improvement
6 days ago
HCSC Chicago, United StatesAt HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career. · Come join us and be part of a purpos ...
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UCAN (Chicago) Chicago, United StatesPosition Title: Quality Improvement Specialist I · Department: Management and General · Reports to: Vice President of Quality Improvement, Impact & Analysis · Position Objective and Summary: · The Quality Improvement Specialist coordinates numerous program evaluation, qualit ...
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5 days ago
City of Lincoln Chicago, United StatesLocation 3605 W. Fillmore, ,Chicago, IL, 60624,United StatesEmployee Type ExemptContact information Email .orgDescription Position Title: Quality Improvement CoordinatorDepartment: Management and GeneralReports to: Vice President of Quality Improvement, Impact & AnalysisPosition ...
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Quality Improvement Coordinator
5 days ago
Esperanza Health Centers Chicago, United StatesEsperanza Health Centers offers benefits to all its full-time employees: · BCBS Medical PPO Plans | Ameritas Dental | Eye Med Vision | 401K | Tuition Reimbursement up to $5,000 per year |10 Paid Holidays and 26 Days of Paid Time Off · Schedule: Full-Time, Monday through Friday ...
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Quality Improvement Coordinator
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Director - Quality Improvement
5 days ago
HCSC Chicago, United StatesAt HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career. · Come join us and be part of a purpo ...
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Quality Improvement Coordinator
6 days ago
City of Lincoln Chicago, United StatesLocation · 3605 W. Fillmore, ,Chicago, IL, 60624,United States · Employee Type · Exempt · Contact information · Email · Description · Position Title: · Quality Improvement Coordinator · Department: · Management and General · Reports to: · Vice President of Quality Improve ...
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Quality Improvement Coordinator
6 days ago
Esperanza Health Centers Chicago, United StatesEsperanza Health Centers offers benefits to all its full-time employees: · BCBS Medical PPO Plans · | · Ameritas Dental · | · Eye Med Vision · | · 401K · | · Tuition Reimbursement up to $5,000 per year · | 10 Paid Holidays and 26 Days of Paid Time Off · Schedule: · Full ...
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Quality Improvement Coord
2 weeks ago
Rush University Chicago, United States**Job Description** · **Location:** Chicago, IL · **Hospital:** RUSH University Medical Center · **Department:** Rush Access Center - Office · **Work Type:** Full Time (Total FTE between 0.9 and 1.0) · **Shift:** **Shift 1** · **Work Schedule:** 8 Hr (8:00:00 AM - 5:00:00 PM) · * ...
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Quality Improvement Specialist
3 days ago
Chicago Family Health Center Inc Chicago, United StatesJob Description · Job DescriptionDescription:Job Title: Quality Improvement Specialist · Compensation (Based on experience and qualifications) · Schedule: Monday - Friday 9:00am - 5:00pm · We are seeking a professional Quality Improvement Specialist, Under the direction of the D ...
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Sinai Chicago Chicago, United StatesAbout Us: · At Sinai Chicago, we take health care personally. Excellence in health care is about more than just medicine, technology, tests and treatments, it is about really caring for people with dignity and respect. That's what we do. We are dedicated to providing the best car ...
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Search Solution Group Chicago, United StatesJOB PURPOSE The Director of Quality Assurance and Continuous Improvement will play a pivotal role in developing, implementing, and managing a comprehensive quality assurance program while driving continuous improvement initiatives across the organization. This strategic role requ ...
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Sinai Chicago Chicago, United StatesAbout Us: · Make sure to apply quickly in order to maximise your chances of being considered for an interview Read the complete job description below. · At Sinai Chicago, we take health care personally. Excellence in health care is about more than just medicine, technology, tes ...
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Sinai Chicago Chicago, United StatesAbout Us: · At Sinai Chicago, we take health care personally. Excellence in health care is about more than just medicine, technology, tests and treatments, it is about really caring for people with dignity and respect. Thats what we do. We are dedicated to providing the best car ...
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Director of Quality and Continuous Improvement
2 weeks ago
Search Solution Group Chicago, IL, United StatesJOB PURPOSE The Director of Quality Assurance and Continuous Improvement will play a pivotal role in developing, implementing, and managing a comprehensive quality assurance program while driving continuous improvement initiatives across the organization. This strategic role requ ...
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Aspen Guard LLC Chicago, United StatesJob Description · Job DescriptionCompany Overview: · Folding Guard is a reputable leader in manufacturing security and safety products. With a strong commitment to innovation and excellence, we serve industries ranging from automotive and logistics to retail and aerospace. We are ...
Director - Quality Improvement - Chicago, United States - Health Care Service Corporation
Description
Director - Quality Improvement page is loadedDirector - Quality Improvement
Apply
locations
IL - Chicago
time type
Full time
posted on
Posted 4 Days Ago
job requisition id
R
At HCSC, we consider our employees the cornerstone of our business and the foundation to our success.
We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.
Come join us and be part of a purpose driven company who is invested in your futureJob Summary
This position is responsible for managing and directing clinical quality improvement and population health oversight activities, driving continuous quality improvement consistent with HCSC goals, regulatory requirements, and accreditation.
The senior director will remain current with best practices and innovations in the areas of quality improvement, population health and clinical quality measurement, and provide guidance and support to local quality teams, FEP, and HCM stakeholders.
Fundamental to the role is a mastery of healthcare quality improvement methodologies and the measurement of healthcare processes and structures that contribute to primary and intermediary health outcomes.
Working knowledge of NCQA, URAC, HEDIS, STARS, FEP, medical policy issues, condition management, social determinants of health/health equity, health informatics, quality improvement best practices and innovative strategies to improve the quality of care and member experience.
Responsibilities include:JOB REQUIREMENTS
:
Bachelor's Degree with 10 years' experience in a healthcare insurance or provider setting in a quality improvement function or oversight role.
5 years
leadership/management
experience
Proven track record in developing innovative quality improvement strategies.
Strong analytical, presentation & clear, concise verbal / written communication skills
Ability to adapt complex concepts to a range of audiences & express complex relationships in simple visual terms.
Executive presence with the ability to influence inside and outside HCSC.
Business and financial acumen; experience with operating, budgeting, and financial forecasting
Experience leading, formulating, and delivering strategy; building strong connections with people and team.
Ability to work effectively within a matrixed organization with multidisciplinary teams, across multiple geographic areas, with attitude toward team building.
Willing and able to travel out of state.
PREFERRED
JOB REQUIREMENTS
:
RN or post-graduate education in Health Care Administration or a health-related field, public health and/or MBA.
Quality experience and Medical Management experience in a leading managed care/insurance or provider organization.
Health Informatics Training
Familiarity with clinical coding and statistical and reporting software.
Knowledge of health care reimbursement models.
Experience in provider and vendor negotiations and contracting models, provider relation and member services.
Familiarity with Government Programs, Stars ratings and Retail products
We encourage people of all backgrounds and experiences to apply.
Even if you don't think you are a perfect fit, apply anyway - you might have qualifications we haven't even thought of yet.
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral processHCSC Employment Statement:
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants.
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace.
Drug screening and background investigation are required, as allowed by law.All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Can't find a suitable opening?
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For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families.
As an industry leader, HCSC also has been helping to make the health care system work better for all Americans.
To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities.
Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions.
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace.
Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment.
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants.
If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at to request reasonable accommodations.
Please note that onlyrequests for accommodations in the application process
will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process.
If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions.
Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas,Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association
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