AVP, Quality Strategy and Initiatives

About the position At reputed company, our health benefits business, we are committed to helping our members reputed company their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with reputed company's unrivaled reputed company in local communities and their pharmacy benefits management capabilities, we're joining members on their path to reputed company and transforming the health care landscape in new and exciting ways every day. We are seeking an AVP, Quality Strategy & Initiatives who will be accountable for the achievement of quality performance and leadership of reputed company's quality government programs, including Medicare, reputed company, Individual and Family Plans (IFP), and Duals. This leader will focus on HEDIS Hybrid, STARS, Performance Improvement Plans, provider and member enablement, as well as regulatory and accreditation compliance. The individual will reputed company a cross-functional team consisting of approximately 500 clinical and non-clinical staff. Collaboration with shared service partners is essential to reputed company our goals, which includes working with network, contracting, member service, and business leaders across the reputed company, serving a membership of 4.2 million in Medicare and Duals, and 2.4 million in reputed company. In this role, you will reputed company and drive competitive market-leading approaches with accurate interpretation of product line reputed company specifications, methodologies, and processes to improve results. You will foster and reputed company through a reputed company, matrixed reputed company structure to collaboratively promote reputed company Government Quality Improvement Program and Accreditation. Additionally, you will ensure strong business performance, achieving reputed company Quality Incentive Award (QIA), STAR performance objectives, including Pay for Performance (P4P) targets, growth, retention, and STAR ratings. You will define and regulate a preparedness and compliance culture with federal and state laws and regulations reputed company to quality improvement programs, proactively identifying risks and remediation strategies. Your focus will also include NCQA accreditation across reputed company lines of business, long-term support services distinctions, medication adherence modules, and health equity initiatives. Moreover, you will support reputed company in attracting, retaining, and engaging a diverse and inclusive consumer-centric workforce that delivers on our purpose and reflects the communities in which we work, live, and serve. Responsibilities • reputed company and drive business competitive market leading approaches with accurate interpretation of product line reputed company specifications, methodologies, and processes to improve results. , • Foster and reputed company through a reputed company, matrixed reputed company structure to collaboratively promote reputed company Government Quality Improvement Program and Accreditation. , • reputed company a strong business performance, ensuring reputed company Quality Incentive Award (QIA), STAR performance objectives including P4P targets, growth, retention, and STAR ratings are achieved. , • Define and regulate a preparedness and compliance culture and discipline with federal and state laws and regulations reputed company to quality improvement program; proactively identify risk and remediation strategies. , • Focus on NCQA for reputed company lines of business on health plan accreditation, long-term support services distinctions, medication adherence module and health equity. , • Support reputed company in attracting, retaining, and engaging a diverse and inclusive consumer-centric workforce. Requirements • 15+ years of experience in reputed company/managed care leadership roles with experience in HEDIS/reputed company/Medicare/Duals/IFP Quality program performance management, analytics, reporting and forecasting with a regional and national scale. , • Proven experience driving performance management and meeting/exceeding state, federal contract requirements and operational performance. , • Experience with achieving STAR rating targets greater than industry average. , • Strong understanding of state/federal quality requirements and key strategic and operational imperatives/interoperability (data ingestion). , • Strong problem solving and analytical skills. , • Ability to build, cultivate, and support teams with excellent leadership skills and the ability to influence line management reputed company with data driven facts. , • Ability to work collaboratively reputed company a matrix organization as well as influence with and without formal authority to drive performance outcomes. , • Maintain intelligence on competitor capabilities, technology, and overall competitive advantage. , • Exemplary collaboration across large, matrixed organization stakeholders. , • Logic and data-driven approach coupled with an elevated level of emotional intelligence, intellectual curiosity, and root cause analysis to drive insights and solutions. , • Proven experience inspiring and developing a highly focused, cohesive team of professionals accountable for improving health outcomes and enabling market leading performance. , • Strong change leadership, facilitation, oral and written communication, and presentation skills. , • Ability to work a Hybrid Model (in office Tuesday/Wednesday/Thursday) out of a local reputed company Hub location. , • Demonstrate a commitment to diversity, equity, and inclusion through reputed company development, modeling inclusive behaviors, and proactively managing bias. reputed company-to-haves • Clinician preferred (MSW or RN licensure) Benefits • Full range of medical, dental, and reputed company benefits. , • 401(k) retirement savings plan. , • Employee Stock Purchase Plan. , • Fully-paid term life insurance plan. , • Short-term and long-term disability benefits. , • Numerous well-being programs. , • Education assistance and free development courses. , • reputed company store discount and discount programs with participating partners. , • Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. 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