Director, Statewide Quality California Medicaid

• Full-time

Location: Thousand Oaks, California

Experience: 10-15 years

Education: Bachelor's Degree

Additional Details: Relocation assistance, Bonus, Occasional Travel

The Director of Clinical Quality Management for the AGP Plan will oversee all quality and NCQA activities for the California Medicaid Business, reporting to the Chief Medical Officer. Primary responsibilities include:

• Providing leadership for the implementation of the Quality Management Program for the California Health Plan.
• Establishing annual goals and objectives.
• Promoting understanding, communication, and coordination of the Clinical Quality Management Program.
• Overseeing Quality Management (QM) Scorecard reporting.
• Leading the development, implementation, and evaluation of Clinical Quality improvement action plans.
• Managing the member/provider satisfaction survey process.
• Overseeing HEDIS reporting and developing action plans to meet improvement targets.
• Supporting the external quality review processes, including audits by the External Quality Review Organization (EQRO).
• Participating in the Quality Improvement Council (QIC).
• Ensuring compliance with NCQA standards or other accrediting bodies.
• Hiring, training, coaching, and evaluating performance of direct reports.

• Bachelor's Degree (BA/BS) required.
• Minimum of 10 years of experience in quality management.
• Experience with HEDIS and health plans preferred.
• RN, MBA, MPH, or additional Quality certifications preferred.

All information will be kept confidential according to EEO guidelines.

Direct Staffing Inc.