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VP Quality - RN

Company: MMS Group
Location: Saint Louis
Posted on: March 18, 2019

Job Description:

VP QUALITY MCO St Louis EXCEPTIONAL leadership team GENEROUS Relocation Working closely with the Chief Medical Director and the CEO VP will oversee all related activities for Quality Improvement functions Lead and direct process improvement activities for more efficient and streamlined workflow Oversee the business processes related to risk adjustment and quality improvement for assigned products and plans Responsible for all activities related to National Committee for Quality Assurance NCQA Accreditation and or Healthcare Effectiveness Data and Information Set HEDIS performance ensuring highest level of accreditation Review and implement new technological tools and processes and foster team concept with internal and external constituencies Present results of improvement efforts and ongoing performance measures and recommend actions plans to senior management Research and incorporate quality improvement best practices into operations Organize and control activities methods and procedures to achieve business objectives Formulate and establish policies operating procedures and goals in compliance with internal and external guidelines Manage and ensure compliance of EPSDT program as well as compliance and turnaround time of grievances and appeals Qualifications: Bachelor s degree in Nursing Master s rsquo; degree preferred Must be a SME in HEDIS and QI process 10 years of health plan MCO ACO operations experience including QI and NCQA accreditation Experience managing acquisition and integration of external data sources Proven leadership experience including responsibilities for hiring training managing performance Experience with succession planning and EI a plus Familiarity with running Risk Adjustment prospective and retrospective programs preferred RN license preferred not required CPHQ preferred not required

Keywords: MMS Group, St. Louis , VP Quality - RN, Executive , Saint Louis, Missouri

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