Blue Cross and Blue Shield of Nebraska · 13 hours ago
Dir Quality & Accreditation
Omaha, NE
Full-time
Hybrid
Director/Executive
10+ years expBlue Cross and Blue Shield of Nebraska is a mission-driven organization dedicated to championing the health and well-being of its members and communities. The Director of Quality & Accreditation will provide strategic leadership for enterprise-wide clinical quality performance and improvement, ensuring regulatory alignment and driving continuous improvement in compliance practices.
Insurance
Responsibilities
Lead strategic direction for quality programs impacting Medicare, Medicaid, ACA, and Commercial lines of business
Develop and execute an enterprise quality roadmap integrating measurement, analytics, reporting, and intervention strategies
Serve as primary liaison with external accreditation bodies (e.g., NCQA, URAC, Joint Commission)
Oversee all accreditation activities, including site visits, audits, and reporting
Lead Quality Improvement Program (QIP) and Quality Assurance and Process Improvement (QAPI) initiatives
Guide creation and interpretation of policies and procedures related to quality of care, improvement, and accreditation
Partner with internal stakeholders and committees to ensure excellent performance on clinical quality measures
Leverage data and analytics to forecast performance, monitor progress, and identify risks and opportunities for improvement
Qualification
Required
Bachelor's degree in Healthcare, Business Administration, Nursing, or related field
10 years of progressive experience in healthcare quality program management, quality improvement, HEDIS operations, and accreditation
Proven leadership in managing enterprise compliance programs and accreditation processes
Strong understanding of federal/state regulations and accreditation standards
Experience with project management and Agile methodologies
Exceptional communication, analytical, and stakeholder engagement skills
The ability to meet or exceed the attendance and timeliness requirements of their departments
The ability to work well in a team environment and be capable of building and maintaining positive relationships with other staff, departments, and customers
Preferred
Master's degree in a related field
Healthcare Quality certification (e.g., CPHQ)
Experience with patient safety initiatives and risk management practices
Familiarity with electronic health records (EHR) systems and value-based care
Demonstrated commitment to DEI and reducing health disparities
Ability to motivate and lead teams through change and process improvement
Company
Blue Cross and Blue Shield of Nebraska
Blue Cross and Blue Shield of Nebraska is the state’s oldest and largest health insurance company, based in Omaha.
1001-5000 employees
H1B Sponsorship
Blue Cross and Blue Shield of Nebraska 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 (10)
2024 (9)
2023 (16)
2022 (15)
2021 (12)
2020 (27)
Funding
Current Stage
Late StageLeadership Team
Chad Werner
EVP and Chief Financial Officer
Steve Konnath
SVP, Chief Actuary and Analytics Officer, Senior Market Segment Leader
Recent News
Fierce Healthcare
2025-07-04
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