Coventry is seeking a dynamic Regional Director of QI for the Southeastern Region
Coventry Health Care; is a national managed health care company based in Bethesda; MD operating health plans; insurance companies; network rental service companies; and workers compensation service companies. Coventry provides a full range of risk and fee-based managed care products and services; including HMO; PPO; POS; Medicare Advantage; Medicaid; Workers Compensation and Network Rental to a broad cross section of employer and government-funded groups; government agencies; and other insurance carriers and administrators. Coventry was recently ranked #168 on the prestigious Fortune 500 and is included in the S&P 500 index.
GENERAL SUMMARY
Directs the quality improvement activities for an assigned region. Establishes strategic plans; policies; and procedures within the region. Interfaces with all business areas to ensure quality programs will meet or exceed guidelines and requirements.
ESSENTIAL RESPONSIBILITIES :
- Assures compliance with all State and Federal quality regulations; Coventry quality standards; and National Committee for Quality Assurance (NCQA) standards.
- Assures the maintenance of accurate documentation of all quality improvement activities; i.e.; surveys; audits; peer reviews; etc.-Remains current with new developments in the field of quality improvement.
- Develops and implements new quality improvement activities within an assigned region.
- Ensures all quality improvement activities are conducted according to Coventry quality standards and all appropriate data and documentation is retained.
- Ensures that quality improvement information; including the monitoring and evaluation of indicators; is collected and reported to the appropriate oversight committees.-Directs data collection for HEDIS measures; identifies opportunities for improvement based on the HEDIS results.
- Controls expenses while meeting operational; functional; and service requirements.
- Recruits; develops; and motivates staff. Initiates and communicates a variety of personnel actions including employment; termination; performance reviews; salary reviews; and disciplinary actions.-Performs other duties as required.Position requires 30%-40% travel.
JOB SPECIFICATIONS
- Bachelor's degree or equivalent experience. Masters degree preferred.-Minimum of 5 years managed care experience with emphasis in quality improvement.-Minimum of 3 years management/leadership experience required.-Certified Professional in Healthy Quality (CPHQ) preferred.
- Extensive knowledge of Quality Program implementation.
- Excellent organizational; managerial; and analytical skills required.-Strong understanding of accreditation; federal; and state regulations/requirements.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer; and we are committed to building a talented and diverse team.
Qualifications:
JOB SPECIFICATIONS
- Bachelor’s degree or equivalent experience. Master’s degree preferred.
- Previous (5-7 years) clinical or health education experience required.
- Previous (3-5 years) quality improvement experience required.
- Previous (5 years) management experience required.
- Certified Professional in Healthy Quality (CPHQ) preferred.
- Excellent organizational, managerial and analytical skills required.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Executive/Senior Level Officials and Managers
Primary Location: Sunrise, FL, US
Other Locations: Morrisville-North Carolina-United States,Atlanta-Georgia-United States
Organization: 32000 - Florida Health Plan Admin. LLC
Schedule: Full-time
Job Posting: 2013-02-06 00:00:00.0
Job ID: 1310327