Vice President, Quality & Process Improvement

Job Description

Position Purpose: Develop and oversee quality improvement programs and strategies for the business unit. Assist in the development and application of the business unit’s strategic mission and vision. Identify and champion the selection of process improvement activities across the enterprise.
Responsible for driving performance improvement for HEDIS, Stars, State Contract Quality & Pay for Performance/Withhold, Marketplace QRS and Medicare Quality metrics and processes and other quality improvement opportunities as needed.

Develop infrastructure and processes for management of activities related to National Committee for Quality Assurance (NCQA) Accreditation and Healthcare Effectiveness Data and Information Set (HEDIS) performance ensuring highest level of accreditation

Oversee the development and implementation of enterprise wide and market specific process improvement programs

Review and present results of quality interventions for clinical and operational performance improvements and identify organizational risks to executive management

Develop and ensure consistent, reliable and valid application of data collection and analysis for priority performance measures, including HEDIS, pay for performance and contractual performance measures

Review and analyze cost benefit and return on investment analyses for organizational resource allocation and recommend action plans

Responsible for building relationship and positioning MHS as the “go to” source for state of the art MCE Quality Metrics.