Dir Quality & Accreditation

Dir Quality & Accreditation page is loaded## Dir Quality & Accreditation locations:
Omaha, NEtime type:
Full time posted on:
Posted 8 Days Agojob requisition :
JR101055

At Blue Cross and Blue Shield of Nebraska, we are a mission-driven organization dedicated to championing the health and well-being of our members and the communities we serve.

Our team is the power behind that promise. And, as the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, there’s no greater time for forward-thinking professionals like you to join us in delivering on it! As a member of Team Blue, you’ll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community.

The ideal candidate will live within driving distance of the Omaha, Nebraska office. This position allows remote flexibility but will have 2-3 days per week in the office.
Provides strategic leadership for enterprise-wide clinical quality performance, improvement, and accreditation standards. Partners with senior leaders and operational teams to ensure regulatory alignment, mitigate risk, and drive continuous improvement in compliance practices.
** What you'll do:
*** Lead strategic direction for quality programs impacting Medicare, Medicaid, ACA, and Commercial lines of business.
* Develop and execute an enterprise quality roadmap integrating measurement, analytics, reporting, and intervention strategies.
* Serve as primary liaison with external accreditation bodies (e.g., NCQA, URAC, Joint Commission).
* Oversee all accreditation activities, including site visits, audits, and reporting.
* Lead Quality Improvement Program (QIP) and Quality Assurance and Process Improvement (QAPI) initiatives.
* Guide creation and interpretation of policies and procedures related to quality of care, improvement, and accreditation.
* Partner with internal stakeholders and committees to ensure excellent performance on clinical quality measures.
* Leverage data and analytics to forecast performance, monitor progress, and identify risks and opportunities for improvement.
** To be considered for this position, you must have:
*** Bachelor’s degree in Healthcare, Business Administration, Nursing, or related field.
* 10 years of progressive experience in healthcare quality program management, quality improvement, HEDIS operations, and accreditation.
* Proven leadership in managing enterprise compliance programs and accreditation processes.
* Strong understanding of federal/state regulations and accreditation standards.
* Experience with project management and Agile methodologies.
* Exceptional communication, analytical, and stakeholder engagement skills.

An equivalent combination of education and experience may be substituted for this requirement. The ability to meet or exceed the attendance and timeliness requirements of their departments. The ability to work well in a team environment and be capable of building and maintaining positive relationships with other staff, departments, and customers.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned.
** The strongest candidates for this position will also possess:
*** Master’s degree in a related field.
* Healthcare Quality certification (e.g., CPHQ).
* Experience with patient safety initiatives and risk management practices.
* Familiarity with electronic health records (EHR) systems and value-based care.
* Demonstrated commitment to DEI and reducing health disparities.
* Ability to motivate and lead teams through change and process improvement.

Learn more about what makes BCBSNE such an exceptional place to work by visiting .
* We strongly believe that diversity of experience, perspective and background will lead to a better workplace for our employees and a better product for our customers and members.
* On the cutting edge of the health care industry, helping Nebraskans in moments of joy, times of hardship and the steps in between.

We are Blue Cross and Blue Shield of Nebraska (BCBSNE), and we exist to be there for people when they need us. Our goal is to add more good, healthy years to people’s lives by supporting our customers and the Nebraska community  have more than 80 years of experience behind us. And a bright future ahead as we continuously innovate to drive health care forward while meeting the needs of our members and state.

If you’re passionate about helping people along their health journeys, we invite you to explore our career offerings.

Here, you will find opportunities to grow personally and professionally while making a difference for our customers and greater Nebraska community.
#J-18808-Ljbffr