Director, Quality Improvement

CarePlus Health Plans Inc

Louisiana, US
Base: $126,300 - $173,700 py; bonus: eligible for ...
Hybrid
Ncqa accreditation compliance
Hedis and cahps measure reporting
Value-based care contracting experience
The Director of Quality Improvement at CarePlus Health Plans Inc. is responsible for implementing and managing quality improvement programs for Louisiana Medicaid, ensuring alignment with organizational strategies and compliance with regulations. The role requires extensive experience in quality management, provider relations, and analytical skills, particularly within a healthcare setting

Job Summary

  • The Director will provide strategic leadership for Humana's Louisiana Medicaid Quality Program while ensuring alignment with enterprise-wide goals.
  • This role requires direct oversight of NCQA accreditation compliance and the development of robust governance structures for value-based provider arrangements.
  • Candidates must possess a deep understanding of operational mechanics including provider contracting, data analytics, and system configuration to drive quality outcomes.

Matching Summary

Match Score: 85

The Director of Quality Improvement at CarePlus Health Plans Inc. is responsible for implementing and managing quality improvement programs for Louisiana Medicaid, ensuring alignment with organizational strategies and compliance with regulations. The role requires extensive experience in quality management, provider relations, and analytical skills, particularly within a healthcare setting.

Salary

Base: $126,300 - $173,700 per year; Bonus: Eligible for incentive plan based on performance; Benefits: Medical, dental, vision, 401(k), paid time off, disability, life insurance

Skills & Requirements

Must-have

  • NCQA accreditation compliance
  • HEDIS and CAHPS measure reporting
  • Value-based care contracting experience
  • Provider relations and education leadership
  • Matrixed environment management skills
  • Data analytics for quality improvement

Nice-to-have

  • Six Sigma quality management training
  • Power BI dashboard analysis skills
  • Humana internal policy knowledge
  • Strong relationship building capabilities
  • Innovative member engagement approaches

Key Requirements

  • Bachelor Degree in Nursing or Medicine
  • CPHQ or CHCQM certification within 6 months
  • 5+ years management experience in quality
  • 5+ years supervisory people management
  • 3+ years provider relations experience
  • Must reside in Louisiana

Work Rights

Must reside and conduct work in the state of Louisiana

Tailored Resume

Cover Letter