6630 Orion Drive, Fort Myers, FL
Department: Innovatus Health
Categories: Management, Professional
Shift: 8:00 AM-5:00 PM
The Quality Director is responsible for developing, implementing and maintaining physician, mid-level and practice level metrics around all quality requirements in value based contract under management. Quality Director will work closely with analytics team and various population health staff, as well as our network of providers to drive action planning around opportunity areas and gaps in quality deliver. Additional Responsibilities may include but are not limited to:
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- The QA Director monitors and conducts audits with the aim to measure elements that have the highest impact to the contracts under management to ensure continued productivity, product knowledge, contact center operations and quality standards are met.
- Provides ongoing feedback including formal one-on-one coaching and immediate feedback sessions with customer service representatives/agents; conduct collaborative feedback sessions with leadership including Supervisors and Team Leads to reinforce learning and process improvement opportunities.
- Working in partnership with operations leadership in improving performance in various plans, analyzes and identifies trends and opportunities for improvement from monitoring activities; unearths root cause of issues, identifies and offers possible solutions and provides actionable insight for performance improvement.
- Identifies developing trends impacting the quality of service and recommends process enhancements or solutions, internally and in the network
- Partners with the Training and Development Department regarding training needs of new and/or current stake holder to assist in the training on QA/QC processes
- Assists with developing training materials and updating resources including but not limited to reference guides, and clinical best practices
- Reviews monitoring tools and processes to ensure auditing consistency and accuracy.
- Actively participate in weekly team huddles to report on performance trends and provide
- expectations for improvement.
- Acts as a subject matter expert for all areas around quality
- Other duties as assigned.
Tuesday & Thursday, 12:30pm - 1:30pm EST. Click on the below link to registerhttps://app.brazenconnect.com/a/leehealth/s/a00oa/next/login
Monday & Friday 12:30pm - 1:30pm EST. Click on the below link to register:https://app.brazenconnect.com/a/leehealth/s/agvq4/next/login
Educational Requirements Required:
- Bachelor's degree required
Minimum of 4 years experience within a managed care organization, health plan, or service delivery network outpatient coding required and 2 years of quality oversight experience HEDIS, CAHPS, HOS and Medicare Star or related clinical quality rating data
State of Florida Licensure Requirements
- NAHQ or NCQA Certification Preferred.