Director Quality Improvement-SWHR

Director Quality Performance Improvement-SWHR (Finance)

At Southwestern Health Resources (SWHR), we believe healthcare can be more integrated, accessible, and affordable for all. Our purpose is simple yet powerful: to build a better way to care, together. SWHR is a patient‑centered, clinically integrated network that brings together academic and community clinicians, researchers, hospitals, and ambulatory facilities. We partner with physicians to drive a new model of value‑based, high‑quality, data‑driven healthcare‑serving everyone in the communities we touch.

By combining the strengths of UT Southwestern Medical Center and Texas Health Resources, we've built the largest provider network in North Texas, giving our team members the opportunity to make a meaningful impact lthcare in the U.S. is evolving rapidly, and SWHR is committed to leading that change‑moving healthcare forward, together.

The Director of Value Based Care Quality and Performance Improvement is responsible for leading enterprise leadership and strategy development for performance improvement in value‑based outcomes across Medicare Advantage, MSSP/ACO, Commercial, ACA and Medicaid lines of business. This role is accountable for driving quality, utilization, cost, and patient experience performance through data‑driven initiatives, provider engagement, regulatory compliance, and cross‑functional collaboration.

Work location: Hybrid, but the expectation is to be in the office Tuesday – Thursday in Farmers Branch

• Strategy & Governance
  • Own and execute the enterprise quality and performance improvement strategy for all value‑based care programs.
  • Provide executive leadership for Medicare Advantage Stars, CMMI, ACO, and other payor programs.
  • Establish governance structures, priorities, and KPIs to achieve measurable improvement in quality, utilization, cost, and patient experience.
• Performance & Contract Management
  • Drive initiatives to improve contractual performance, realize at‑risk revenue, and maximize shared savings.
  • Implement action plans to meet risk‑based and shared savings contract success, including monitoring and improving cost and utilization metrics such as ED/1000, Admits/1000, MLR, PMPM.
  • Identify enterprise value‑based care program risks and implement mitigation strategies.
• Quality & Compliance
  • Ensure accuracy, integrity, and timely submission of quality data, including HEDIS, Stars, and supplemental data.
  • Oversee audit readiness, submissions, corrective action plans, and accreditation activities.
  • Serve as subject matter expert on CMS, CMMI, HEDIS, NCQA, and payer regulations and emerging requirements.
• Data Insights
  • Translate complex performance data into actionable insights through dashboards and executive‑level reporting.
  • Monitor patient experience and utilization data to identify and prioritize opportunities for improvement and collaborate with vendors.
• Collaboration & Provider Engagement
  • Partner with contracting, finance, and operations to align quality, utilization, patient experience and overall total cost of care (TCOC) incentives with organizational goals.
  • Collaborate with provider relations, medical economics, clinical leadership, and care management teams to improve provider performance.
  • Lead workflow optimization initiatives supporting EMR documentation, reporting, and compliance.
  • Knowledgeable of CAHPS and other patient experience surveys in the public domain that impact public reporting and value‑based reimbursement.
• Vendor & Team Leadership
  • Manage vendor performance related to value‑based care analytics, supplemental data, and improvement initiatives.
  • Lead, coach, and retain high‑performing teams; develop departmental budgets and workforce plans.
• Executive Reporting
  • Serve as primary executive contact for payer quality and patient experience discussions.
  • Prepare and present performance results, trends, and strategic recommendations to senior leadership.
  • Other duties as assigned.

• Bachelor's Degree in Healthcare Administration, Public Health, Nursing, or related field required.
• Master's Degree in Healthcare Administration, Public Health, Nursing, or related field preferred.

• 8 years with…