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Role Overview:
- Lead and direct clinical, quality, and risk adjustment functions to improve member outcomes.
- Develop and oversee programs focused on physician education, provider communication, and quality improvement.
- Partner with cross-functional teams to coordinate initiatives and prioritize provider engagement.
Key Responsibilities:
- Establish tracking and reporting systems for quality improvement activities.
- Monitor high-risk events and analyze performance data to identify trends and opportunities.
- Lead and evaluate team performance, providing coaching and professional development.
Qualifications:
- Bachelor's degree in Healthcare, Nursing, Public Health, or related field.
- 3+ years supervisory experience and 5+ years in managed care.
- Strong knowledge of HEDIS, quality improvement, and risk adjustment.
Jobgether
Our partner is a healthcare organization focused on improving access, quality, and outcomes. They operate in a managed care environment with a collaborative, purpose-driven culture.