Cambia Health Solutions Hiring for Assistant Director (AD) – Federal Employee Program (FEP) Quality and Plan Incentive Performance (PIP) – R-2882_404838856 at LEWISTON, Idaho Full Time

This job was posted by https://idahoworks.gov : For more information,
please see: https://idahoworks.gov/jobs/1974233 Assistant Director
(AD) – Federal Employee Program (FEP) Quality and Plan Incentive
Performance (PIP)

Teleflex/Onsite Flex Options (No Telecommute/Remote) – Must reside in
ID, OR, UT or WA (Tacoma WA Preferred)

WHO WE NEED

The Assistant Director of the FEP Quality & PIP provides direction and
leadership for the development, implementation, and management of
quality & PIP management functions across all FEP plans (including
quality outcomes, quality improvement initiatives, and related PIP and
quality compliance functions). Ensures programs and program results
meet/exceed business needs, are market competitive, compliant with
regulatory standards and designed to improve the quality of service and
health care outcomes for members. As part of the FEP Leadership Team
establish business objectives, allocate resources, and drives results.
Represents FEP Quality & PIP in interactions with all levels of
management, supplier partners, government representatives, providers,
and outside consultants.

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Preferred Key
Experience:***

• Five years of management/leadership experience or equivalent
  combination of education and experience.
• HEDIS/CAHPS measurement and reporting knowledge and experience
  preferred to drive quality initiatives for the FEP line of
  business.
• Knowledge of FEP quality and PIP requirements and demonstrated
  ability to manage compliant operations preferred.
• Collaborates within FEP and with Clinical staff, Health Informatics,
  Provider Services, and other departments as needed to drive quality
  and PIP improvements as well as collect, analyze, and report on
  metrics and effectiveness of programs.
• Leads identification and implementation of quality improvement and
  population health programs that improve quality and PIP performance
  (including the evaluation of and contracting with suppliers as
  needed).

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YOUR ROLE**

• Provides leadership in developing, implementing, and communicating
  short and long-range plans, goals, and objectives for the FEP
  Quality & PIP functions. Aligns team goals with the FEP
  organization’s vision and strategy.
• Manages the organization by ensuring clear performance expectations
  along with appropriate skills sets.
• Fosters an effective work environment and ensures employees receive
  recognition, feedback, and development. Participates in
  organizational talent management and succession planning.
• Determines appropriate staffing levels and resource needs, creates,
  and manages department and/or project budget, allocates resources,
  and approves expenditures.
• Ensures FEP Quality & PIP programs achieve desired outcomes and
  meet/exceed quality and PIP metrics.
• Collaborates within FEP and with Clinical staff, Health Informatics,
  Provider Services, and other departments as needed to drive quality
  and PIP improvements as well as collect, analyze, and report on
  metric and effectiveness of programs.
• Leads identification and implementation of quality improvement and
  population health programs that improve quality and PIP performance
  (including the evaluation of and contracting with suppliers as
  needed).
• Ensures education and training for leadership and staff and business
  associates as to the quality management plan and their respective
  responsibilities.
• Represents the FEP organization in a variety of internal and
  external forums focused on quality improvement.

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WHAT YOU BRING***

• Dem onstrates ability to lead high performing teams, manage managers,
  and direct suppliers.
• Strong communication and facilitation skills with all levels of the
  organization, including the ability to resolve issues and build
  consensus among groups of diverse stakeholders.
• General business acumen including understanding of market dynamics,
  financial/budget management, data analysis and decision making.
• Knowledge of health insurance industry trends and technology.
• Knowledge of Quality improvement theory, research design and
  statistics in the healthcare setting.
• Demonstrates ability to create, advocate for and execute FEP Quality
  & PIP programs that achieve desired outcomes targets and drive
  performance across internal teams, the delivery system and/or
  suppliers.
• Knowledge of FEP quality and PIP requirements and demonstrated
  ability to manage compliant operations preferred.
• Health Plan Accreditation (NCQA or URAC) and HEDIS/CAHPS measurement
  and reporting knowledge and experience preferred.
• Ability to decipher and interpret quality and PIP data and deliver
  presentations to various internal/external audiences related to
  outcomes.

Normally to be proficient in the competencies listed
above:

The Assistant Director FEP Quality & PIP would have a Bachelor’s degree
in health care, business or related field, 5-7 years of progressively
responsible health care or health insurance e