Quality Improvement Director - Healthcare jobs in Louisiana

This job is responsible for developing, managing and integrating a comprehensive approach through cross-functional organizational teams to improve STAR ratings, including upcoming changes to HEDIS, HOS, CAHPS, and health equity and how they influence overall STAR performance. Works in collaboration with Hedis team and responsible for customized action plans focusing on enhancing performance in key areas impacting STAR ratings such as disenrollments, appeals, provider network and member experience. Required to develop frameworks, analytic platforms, tools and/or models for consistently analyzing, interpreting, and extracting data relevant to Star Ratings. Integrates diverse data sources to gain a comprehensive view of the population by combining health data with SDOH, demographic and behavioral data. Development of concrete blueprints outlining steps for implementing change, based on problem-solving sessions and strategic planning across the organization, including medical management teams. This should include process improvement initiatives, technology adoption plans, or patient engagement strategies. Development of comprehensive reports or studies comparing the organization’s performance against industry standards or competitors. Applies methodologies like the PDSA cycle for implementing strategic initiatives and continually refining these processes based on results and feedback. The Director will independently make decisions that could seriously affect the overall and strategic results.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.

This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company’s discretion.

Required - Bachelor’s degree in Nursing, Public Health, Business Administration, or related fields.

Preferred - Master’s degree in Nursing, Public Health, Business Administration, or related fields.

Required - 10 years’ experience in healthcare leadership; Experience with healthcare quality, relational databases, and systems analysis; Experience with robust process improvement; Experience with documentation effectiveness tools (Crimson, Truven, 3M, Tableau, Vizient CDB) and analysis of ICD-10-CM data relating to externally reported quality methodologies including AHRQ PSI and CMS HAC.

Preferred - Active Certified Professional in Healthcare Quality (CPHQ) certification.

The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time.

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