Director of Quality Improvement
JOB SUMMARY
The Director of Quality Improvement is responsible for the strategic leadership, development, implementation, and oversight of the organization’s Quality Improvement (QI) Program within a healthcare Management Services Organization (MSO) environment. This role ensures compliance with applicable federal and California state regulations, including DMHC, CMS, and NCQA standards, as well as health plan contractual requirements. The Director works collaboratively with executive leadership, affiliated Independent Practice Associations (IPAs), medical groups, providers, and health plans to drive measurable improvements in clinical quality, patient safety, access to care, member satisfaction, and population health outcomes. The position requires strong analytical capabilities, regulatory expertise, and leadership skills.
Requirements
Minimum: Bachelor’s degree in Healthcare Administration, Nursing, Public Health, or related field. Five (5) years of experience in healthcare quality improvement, managed care, or healthcare compliance. Two (2) years of leadership of supervisory experience.
Preferred: Master’s degree (MPH, MHA, MBA, or related clinical discipline). Experience within a California MSO, IPA, or health plan environment. Direct experience with HEDIS, CMS Star Ratings, and NCQA accreditation.
Preferred: Certified Professional in Healthcare Quality (CPHQ), current California Registered Nursing (RN) License.
Skills, Knowledge & Abilities
Strong knowledge of DMHC, CMS, NCQA, and managed care regulations
Advanced analytical and data interpretation skills
Excellent written, verbal, and presentation communication skills
Ability to influence cross-functional teams and provider networks
Strong organizational, leadership, and project management skills
Proficiency in Microsoft Office and healthcare data/reporting systems
Physical, Mental & Environmental Requirements
Prolonged periods of sitting, frequent use of a computer, and extensive data analysis
Frequent travel within California, which may comprise up to approximately 50% of the employee’s time, for purposes such as site visits, audits, and meetings
Ability to communicate effectively and clearly in person, by telephone, and in written formats
Ability to manage multiple priorities and deadlines in a dynamic, fast-paced healthcare environment
PAY RANGE
$130,000.00 - $145,000.00 / annually