Employer Industry: Healthcare Services

Why Consider this Job Opportunity:
- Salary up to $151,700.00 per year
- Comprehensive benefits package including health insurance, 401K, stock purchase plans, and tuition reimbursement
- Flexible work approach with remote, hybrid, field, or office work schedules
- Opportunity for career advancement and growth within the organization
- Competitive pay and incentives based on individual skills and experience
- Chance to make a positive impact on clinical quality and member experience metrics

What to Expect (Job Responsibilities):
- Lead the development of provider quality programs in alignment with strategic initiatives
- Design and implement provider quality workflows and integration efforts
- Conduct needs assessments and provide timely information to stakeholders
- Collect and summarize program performance data for leadership review
- Develop evaluation methodologies for quality programs

What is Required (Qualifications):
- Bachelor's degree in Health Care Administration, Health Sciences, Business Administration, or related field
- 5+ years of related health insurance experience, including provider relations or provider quality experience
- Experience with Provider Quality Incentive programs, Medicare Stars, Marketplace QRS, and State Medicaid P4P Programs
- Strong communication and leadership skills
- Ability to work collaboratively with cross-functional teams

How to Stand Out (Preferred Qualifications):
- Knowledge of HIPAA regulations and compliance
- Experience working in a managed care environment
- Familiarity with quality improvement methodologies
- Certification in quality management or related field
- Proficiency in data analysis and reporting

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