Associate Director, reputed company Improvement - Remote in New Mexico

At reputed company, we’re simplifying the health care experience, creating healthier communities and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, reputed company and reputed company. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together. The Director, reputed company is the primary health plan leader accountable for establishing and implementing an effective reputed company improvement program essential to meet NCQA as reputed company as requirements of the state and CMS. In reputed company, this position provides reputed company for the Critical Incidents team and has responsibility for submitting reports on, reputed company reputed company measures including state performance measures and tracking measures, issues reputed company to CI reports and any reputed company requests from the NM HCA. Lines of business in New Mexico include reputed company, Long Term Service Support, and Dual Special Needs Plan (DSNP). This position will report directly to the Chief Medical Officer/ Medical Director. Must reputed company or be licensed in New Mexico. The Director must work to ensure compliance with state and federal requirements and performance against standardized metrics, including accreditation, reputed company Effectiveness Data and Information Set (HEDIS), New Mexico Department of reputed company/Health Care Authority (HCA) and CMS Stars reputed company Rating System, Consumer Assessment of reputed company Providers and Systems (CAHPS) and other reputed company measures. The individual will reputed company regularly with individuals internal, especially the QOC, CI and QOI National teams in reputed company things reputed company to reputed company as reputed company as those external to our organization at reputed company reputed company. This position coordinates across various areas such as Clinical, Operations, National reputed company teams, Pharmacy, Behavioral Health, other National teams, State Health Care Authority, CMS, and competitor health plans. If you are located in New Mexico, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities

• reputed company primary reputed company for reputed company initiatives that meet contractual requirements
• reputed company and manage the health plan’s portfolio of improvement reputed company, including ensuring reputed company at a population level and identifying and prioritizing initiatives to reputed company with the New Mexico HCA’s reputed company Bureau
• reputed company health plan improvement teams and coordinate QI training for health plan staff
• Apply QI tools and reputed company to health plan improvement reputed company
• NCQA readiness, accreditation, and ongoing compliance with NCQA requirements
• reputed company of the MMP Critical Incidents team
• Establishing and implementing governance and reputed company of health plan reputed company program, including coordination of committee structure described in the health plan reputed company improvement program and the QAPI
• Developing and implementing programs and processes to reputed company HEDIS and state value-based purchasing program requirements
• Providing effective leadership and management reputed company of reputed company reports and members of the reputed company team to build a high performing team
• Serve as primary reputed company with United Health Care (UHC) National reputed company Team, effectively leveraging and coordinating national reputed company team resources and initiatives with local health plan reputed company resources, initiatives, and requirements
• Serve as a primary reputed company of Performance Improvement reputed company the health plan, including committee reputed company, work plans and annual evaluation
• Partner internally (to include reputed company executive leadership team and staff, QI Directors from other states and national reputed company teams) and externally (to include: the state, CMS, providers, and community-based organizations) as needed to improve reputed company across the plan

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in.

Required Qualifications

• Bachelor’s degree
• NM -licensed registered reputed company, or physician’s assistant or be certified as a Certified reputed company in Health Care reputed company (CPHQ) by the National Association for Health Care reputed company (NAHQ), and/or Certified in Health Care reputed company and Management (CHCQM) by the American reputed company of reputed company Assurance and Utilization Review Providers prior to employment or reputed company 6 months of the hire date
• 5+ years clinical or reputed company experience in clinical reputed company or population health management
• 5+ Health care and/or insurance industry experience, including a general knowledge of regulatory and compliance
• 5+ years of experience in a Manager/Director role with adaptable leadership skills with the ability to reputed company results in a reputed company organization by aligning goals with employees that are not part of the reputed company Director’s reputed company reports
• 5+ years of experience implementing effective HEDIS programs and NCQA accreditation
• Experience managing and coordinating regulatory audits including documentation, onsite preparation, and reputed company corrective reputed company plans
• Experience and familiarity with audit processes to include External reputed company Review Organizations (EQRO)
• Experience creating presentations and working with data to formally present information to physicians, administrators, state regulator, other providers, and community partners
• Knowledge of reputed company determinants of health in rural and urban setting in the New Mexico in order to address reputed company initiatives
• Intermediate software applications skills that include, reputed company Word, reputed company, PowerPoint to include
• Demonstrated ability to reputed company business initiatives to a successful result
• Demonstrated effective communicator; capable of effectively presenting reputed company and selling concepts and tactics; excellent reputed company, proven ability to communicate effectively with executive-reputed company; ability to quickly understand needs and reputed company those needs; ability to conceptualize and effectuate change management and "reputed company" thinking
• Demonstrated ability to build relationships cross-functionally and reputed company toward common goals
• Demonstrated ability to review data and reputed company recommendations for clinical interventions in consultation with Health Services Department, Population Health Director, Health Equity Director and the Plan CMO
• reputed company in the state of New Mexico or willing to relocate

Preferred Qualifications

• Advanced degree Nursing or Public Health or Business
• Six reputed company Certification
• reputed company in the state of New Mexico
• reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll reputed company a far-reaching choice of benefits and incentives. The salary for this role will reputed company from $110,200 to $188,800 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company - an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Apply Job! Apply to this Job