Health Care Service Corporation · 2 hours ago
Director, Quality Improvement
Chicago, IL
Full-time
Hybrid
Senior Level, Lead/Staff
$119K/yr - $221K/yr
10+ years expHealth Care Service Corporation is a purpose-driven company that invests in the professional development of its employees. The Director of Quality Improvement is responsible for managing clinical quality improvement and population health oversight activities, driving continuous quality improvement aligned with the company's goals and regulatory requirements.
Health InsuranceInsurance
Responsibilities
Oversee a team responsible for evaluating and developing quality improvement and population health programs and initiatives that lead to improvements in clinical quality outcomes, with attention to care disparities and social determinants of health
Work with the Enterprise Quality Reporting (EQR) team to identify line of business and regional variations in clinical quality measures and population health statistics to inform targeted solutions
Collaborate with EQR to design, deliver and communicate reporting tools to support quality improvement and accreditation efforts
Work with the quality, data science and analytics teams to measure the impact of existing quality programs, design and communicate initiatives that effectively target variations in healthcare measures
Collaborate with Quality Operations team to coordinate quality improvement outreach efforts and initiatives and that support Accreditation Governance strategy
Partner with EQ&A and Quality Improvement Committee Meetings around quality best practices
Develop, review and sign off on relevant policies and procedures
Maintain regular communication with management regarding developments within areas of assigned responsibilities and perform special projects as required or requested
Maintain currency with HEDIS, Hospital and other quality data sets, accreditation standards and a knowledge of market place, products, health care initiatives, technology, etc
Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies
Support and/or provide cross coverage in support of additional functions to ensure seamless execution of divisional priorities
Maintain complete confidentiality of company business
Overseeing the annual budget and allocating resources for various projects and operational needs
Translating needs and initiatives into compelling business cases
Conducting cost-benefit analyses to justify investments and ensure ROI
Other duties as assigned
Qualification
Required
Bachelor's Degree with 10 years' experience in a healthcare insurance or provider setting in a quality improvement function or oversight role
5 years leadership/management experience
Proven track record in developing innovative quality improvement strategies
Strong analytical, presentation & clear, concise verbal / written communication skills
Ability to adapt complex concepts to a range of audiences & express complex relationships in simple visual terms
Executive presence with the ability to influence inside and outside HCSC
Business and financial acumen; experience with operating, budgeting and financial forecasting
Experience leading, formulating and delivering strategy; building strong connections with people and team
Ability to work effectively within a matrixed organization with multidisciplinary teams, across multiple geographic areas, with attitude toward team building
Able to meet deadlines under pressure
Willing and able to travel out of state
Preferred
RN or post-graduate education in Health Care Administration or a health-related field, public health and/or MBA
Quality experience and Medical Management experience in a leading managed care/insurance or provider organization
Health Informatics Training
Familiarity with clinical coding and statistical and reporting software
Knowledge of health care reimbursement models
Experience in provider and vendor negotiations and contracting models, provider relation and member services
Familiarity with Government Programs, Stars ratings and Retail products
Company
Health Care Service Corporation
Health Care Service Corporation is a customer-owned health insurance company.
10001+ employees
H1B Sponsorship
Health Care Service Corporation has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (198)
2024 (166)
2023 (132)
2022 (145)
2021 (73)
2020 (59)
Funding
Current Stage
Late StageLeadership Team
Manika Turnbull
Senior Vice President & Chief Human Resources Officer
Recent News
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