Sr. Director, Quality and Safety Improvement

Job Summary:

The Senior Director of Quality is responsible for overseeing and managing the quality of care provided under government programs, including Medicare, Medicaid, other federally funded healthcare initiatives, and Commercial lines of business. This role is key in ensuring compliance with federal and state regulations, to ensure that the organization meets or exceeds all required quality metrics and performance standards, while improving patient outcomes and reducing disparities across all lines of business.

Drives the strategic planning for a broad range of administrative, facilitation, and technical support functions in the area of Quality and Safety Improvement to support Quality and Safety programs and initiatives. Oversees the strategic direction regarding the development, implementation, monitoring, and continuous improvement of Quality and Safety programs and initiatives. Provides realistic plans that direct teams toward the long-term strategic direction for collecting, analyzing, and trending data to identify opportunities to improve quality and safety, decrease risk, and maintain the KP safety culture.

Defines the standards to address priority issues and acts as a technical expert for issues related to quality and safety. Proactively engages internal and external committees, projects, and relevant initiatives to actualize change and determine necessary infrastructure changes to move quality and safety initiatives forward and ensure future KP compliance.

Essential Responsibilities:

+ Builds organizational capacity and prepares high potentials for growth opportunities and advancement; builds collaborative networks inside and outside the organization for self and others. Provides framework for soliciting and acting on performance feedback; drives collaboration to set goals and provide open feedback and coaching to foster performance improvement. Models and drives continuous learning and oversees the recruitment, selection, and development of talent;

stays current with industry trends, benchmarks, and best practices; ensures performance management guidelines and expectations to achieve business needs. Acts as a thought leader on industry trends, benchmarks, and best practices; shares best practices within and across teams to drive improvement. Motivates and empowers teams; maintains a highly skilled and engaged workforce by aligning cross-functional resource plans with business objectives.

Provides guidance when difficult decisions need to be made; creates opportunities for expanded scope of decision making and impact across teams.

+ Oversees the operation of multiple units and/or departments by identifying member and operational needs; ensures the management of work assignment allocation and completion; translates business strategy into actionable business requirements; ensures products and/or services meet member requirements and expectations while aligning with organizational strategies. Engages strategic, cross-functional business units to champion and drive support for business plans and priorities; assumes responsibility for decision making;

sets standards, measures progress, and ensures resolution of escalated issues. Sets and communicates goals and objectives; analyzes resources, costs, and forecasts and incorporates them into business plans; obtains and distributes resources. Anticipates and removes obstacles that impact performance; addresses performance gaps and implements contingency plans accordingly; ensures teams accomplish business objectives; serves as a subject-matter expert and trusted source to executive leadership;

provides influence and consultation in the development of the larger organizational or business strategy.

+ Directs data collection and analyses to support quality improvement reporting by: overseeing statistical analysis for quality improvement evaluations, special projects, and other work for multidisciplinary review; establishing the long-term plans for the integration and use of multiple utilization data reporting systems to develop and maintain a variety of statistical reports to support evidence driven improvement across KP; presenting and interpreting quality improvement metric reports to executive management to demonstrate improvements and effectiveness of quality improvement programs to a variety of technical and nontechnical audiences, such as executive management and external agencies;

and serving as a technical expert to executive internal and external stakeholders by advising on strategies to improve data collection, analysis, and reporting, at the organizational level to monitor success of long-term success of KP goals/objectives.

+ Oversees current and director future quality improvement and improvement risk management efforts by: implementing corrective action plan for improvement identified through utilization review, clinical records audit, claim denials, member satisfaction surveys, and auditing surveys at the executive level to guide long-term…