Director of Quality Improvement, Member Experience, & Health Equity

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Lead the strategy. Improve outcomes. Advance health equity. Transform the member experience.

Health New England is seeking an accomplished and forward-thinking Director, Quality Improvement, Member Experience & Health Equity to provide strategic and operational leadership across our Medicare, Medicaid, and Commercial lines of business.

This is an opportunity to shape how quality, member experience, health equity, and clinical performance come together to create better outcomes for the communities we serve.

Reporting to the Vice President, Chief Medical Officer, the Director of Quality Improvement, Member Experience, & Health Equity will drive enterprise-wide strategies that improve clinical quality, member satisfaction, health equity, regulatory performance, and accreditation results. A key differentiator of this role is the opportunity to collaborate closely with Baystate Health, leveraging the integrated health plan/provider relationship to connect health plan quality priorities with clinical delivery.

You’ll help advance data sharing, care-gap closure, provider performance, value-based care, and coordinated improvement initiatives — helping make the payvider model a true competitive advantage.

Develop and execute enterprise-wide strategies, annual work plans, goals, and performance measures across Quality Improvement, Member Experience, and Health Equity.

• Establish strategic priorities aligned with organizational objectives.
• Lead quality improvement and member-centered performance initiatives.
• Chair or co-chair quality, health equity, member experience, and related governance committees.
• Partner with the Chief Medical Officer and executive leadership to improve clinical outcomes, member satisfaction, and operational effectiveness.
• Present performance results, opportunities, and recommendations to Executive Leadership, Quality Committees, and Board Committees.
• Oversee quality audits, corrective action plans, regulatory reporting, and continuous improvement initiatives.

Provide strategic oversight across multiple lines of business while translating complex performance data into focused improvement strategies.

• Advance Medicaid ACO quality outcomes.
• Optimize HEDIS, CAHPS, HOS, preventive care, and care-gap performance.
• Meet state, CMS, NCQA, and Commercial quality requirements.
• Partner with clinical, operational, and vendor teams to address measure-specific opportunities.
• Support growth and retention through exceptional quality and member experience.

Serve as an executive champion for health equity and help embed equitable care and service principles throughout the organization.

Lead the ongoing achievement and maintenance of NCQA Health Equity Accreditation
, including:

• Health equity governance and strategy.
• Disparity identification and reduction.
• Demographic and disparity-related data collection and analysis.
• Health equity dashboards, goals, and reporting.
• Regulatory and accreditation readiness.
• Strategies to improve access, clinical outcomes, and member experience across populations.

Build strong partnerships with Provider Network Management, Population Health, Baystate Health, and network providers to improve quality and outcomes.

• Improve provider quality performance.
• Advance value-based care and provider incentive programs.
• Improve preventive care and chronic disease management.
• Strengthen…