Associate Vice President, Quality Operations(Preferred Managed Care Experience)

Job Summary:

The Associate Vice President, Quality Operations is responsible for driving quality performance results across multiple markets. They will develop and lead quality strategy and ensure effective execution of both market and enterprise quality programs to achieve enterprise quality goals.

Essential Functions:

• Develop and execute on quality strategy for multiple markets, working collaboratively with market and enterprise senior leaders, to achieve accreditation, state and other regulatory quality performance standards and enterprise quality goals
• Oversee Quality Committee performance ensuring necessary participation, effectiveness and alignment of Committee activities and outputs with regulatory standards
• Develop and implement standardized quality improvement initiatives, programs, tools and innovations to improve market performance and delivery of high-quality care and services across the Enterprise
• Monitor effectiveness of quality programs and interventions, utilizing quality tools and continuous quality improvement framework
• Monitor and report out on key quality and performance indicators and associated interventions
• Identify and mitigate quality performance deficits in Markets and lead collaboratively across teams to facilitate appropriate engagement of enterprise, operational and market resources
• Influence quality outcomes through the development, implementation and monitoring of remediation strategies to improve HEDIS, NCQA and Star program results
• Manage relationships with state departments and quality organizations as needed
• Drive a culture of continuous quality improvement across the organization
• Collaborate in the development, implementation, support and evaluation of provider performance programs including value-based agreements and data/programs supporting provider performance management
• Lead the alignment and collaboration between Market/Product teams and Enterprise activities to ensure timely and accurate responsiveness and resolution to any systems, regulatory, or compliance issues related to quality
• Other job duties as requested

Education and Experience:

• Bachelor of Science degree in healthcare field or equivalent years of relevant work experience is required
• Master's degree in healthcare or business is preferred
• Minimum of five (5) years of leadership and management experience in managed care setting is required
• Minimum of five (5) years of quality improvement in the healthcare or managed care industry is required

Competencies, Knowledge and Skills:

• Intermediate proficiency level with Microsoft Office
• Knowledge of full range of product requirements from regulatory, operations, and compliance
• Critical listening and systematic thinking skills
• Ability to attract, manage and develop team members through inspirational leadership
• Ability to maintain confidentiality and act in the company's best interest
• Strong oral, written, and interpersonal communication skills
• Ability to act with diplomacy and sensitivity to cultural diversity
• Responsive to a changing environment
• Health Plan Financial & Administration Management Acumen
• Strategic management skills
• Conflict resolution skills
• Planning, problem identification and resolution skills

Licensure and Certification:

• Clinical licensure is preferred
• Certified Professional in Healthcare Quality (CPHQ) preferred
• To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
• CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• This role may require up to 20% travel based on the needs of the department

Compensation Range:
$150,000 - $300,000. CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type:
Salary

Competencies:
- Create an Inclusive Environment
- Cultivate Partnerships
- Develop Self and Others
- Drive Execution
- Energize and Inspire the Organization
- Influence Others
- Pursue Personal Excellence
- Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.