Company:AHI agilon health, inc.
Job Posting Location:Remote - USA
Job Title: Director, Quality Performance
Job Description:
The Director of Quality Performance is responsible for the development and implementation of the organization’s quality improvement strategy. They will lead the day-to-day operations of the quality program and support strong stakeholder collaboration with all things related to the Stars program including HEDIS, Medication Adherence and CAHPS. The Director of Quality Performance will oversee process improvement activities, health plan engagement, patient experience, quality data ingestions, submissions, analytics and reporting.
Essential Job Functions:
Quality Improvement Strategy:
-
Develop, implement and execute a comprehensive quality improvement strategy aligned with organizational goals.
-
Collaborate with cross-functional teams to enhance clinical outcomes, patient satisfaction, and overall quality of care.
HEDIS and Stars Performance:
-
Manage HEDIS and Stars data collection, reporting, and analysis.
-
Drive initiatives to improve HEDIS and Stars scores, ensuring compliance with national benchmarks.
-
Implement evidence-based practices to enhance preventive care, chronic disease management, and member engagement.
Leadership and Collaboration:
-
Lead and manage a team of quality professionals, including Quality Managers, and HEDIS Analysts,
-
Collaborate with clinical leaders, providers, and network partners to align quality goals and drive performance improvement.
Risk Adjustment and Coding Accuracy:
-
Work closely with coding teams to optimize risk adjustment and quality processes.
Quality Metrics and Reporting:
-
Monitor and report on key quality metrics, identifying trends and areas for improvement.
-
Present findings to executive leadership and recommend actionable strategies.
Regulatory Compliance:
-
Stay informed about CMS (Centers for Medicare & Medicaid Services) regulations related to quality measures.
-
Ensure compliance with all relevant guidelines and requirements.
Required Qualifications:
Minimum Experience
-
10+ years of experience in quality management, quality improvement, or healthcare operations.
-
4+ years’ experience in leading high performing teams and managing people
-
Must have firm understanding of Stars, HEDIS and CAHPS.
-
Must be analytical
-
Must have excellent collaboration and communications skills and can influence change across teams
-
Understand medical records or have ability to read clinical records
Education/Licensure:
-
Bachelor’s degree required
-
Master’s degree preferred
Location: Remote - AZPay Range: $129,700.00 - $162,100.00
Salary range shown is a guideline. Individual compensation packages can vary based on factors unique to each candidate, such as skill set, experience, and qualifications.
What We Do
agilon health is transforming health care for seniors by empowering primary-care physicians to focus on the entire health of their patients. Through our platform and partnership model, agilon health is leading the nation in creating the system we need – one built on the value of care, not the volume of fees. We honor the independence of local physicians and serve as their long-term partner so they can be the physicians they trained to be.
agilon is built for physicians by physicians, as the patient-physician relationship is the cornerstone of care. We allow primary care physicians to take the long view of their relationships with patients, and to be confident in the long-term financial viability of their own practices. We do this through a Total Care Model that maintains the independence of physicians; unites them in a network of like-minded leaders; and integrates all of the components of a global risk business model into a single platform.
