We are seeking a dynamic leader to oversee a team of Practice Transformation Advisors and collaborate on tailoring and implementing Quality and Practice Transformation strategies across our provider network in Illinois. This role focuses on aligning practice operations and capabilities with Medicaid member needs to optimize health outcomes and practice earning opportunities under Pay for Performance (P4P) initiatives. Working closely with our Value-Based Care (VBC) team, you will drive the implementation of clinical best practices in partnership with primary care providers to enhance performance across the board. The position is pivotal in supporting the achievement of the quintuple aim by enhancing provider experience and improving population health outcomes. Utilizing innovation, integration, and data-driven insights, you will link quality management activities directly to business goals.
Key Responsibilities
Lead and support health care quality projects and initiatives through strategic direction and proactive leadership.
Develop and implement quality activities aligned with company strategies and values.
Build strong internal and external relationships while serving as a subject matter expert on quality programs to influence business strategies.
Manage Health Care Quality Management functions including QM Programs/Infrastructure, behavioral health QM, credentialing, delegation, regulatory accreditation support, clinical and service measurement and improvement, and quality of care investigations.
Required Qualifications
8+ years of leadership experience in a Medicaid or Medicare managed care environment.
Extensive experience in HEDIS, STARs, population health, provider practice improvement, and proficiency in data analytics.
Preferred Qualifications
Clinical RN or related health care licensure.
Clinical and/or Quality Certification (e.g., CPHQ, Lean Six Sigma).
Education
Bachelor's degree in a health-related field; Master's degree preferred.
Compensation
The typical pay range for this role is between $79,200.00 - $174,200.00 annually. The actual base salary offer will be determined based on factors such as experience, education, and geographic location. This position is eligible for additional compensation through Health's bonus, commission, or short-term incentive programs.
Benefits
In addition to competitive compensation, we offer a comprehensive benefits package including medical, dental, and vision coverage, a 401(k) retirement savings plan, Employee Stock Purchase Plan, life insurance, disability benefits, well-being programs, education assistance, development courses, store discounts, and various discount programs with partner organizations. Paid Time Off (PTO), vacation pay, and paid holidays are provided according to state law and company policies.
Application
If you are a seasoned leader passionate about healthcare quality management and driving impactful change, we encourage you to apply. Join us in making a difference in healthcare delivery and community well-being.
Employment Type: Full-Time
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Health Care Provider
Industries
Human Resources Services
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