What are the responsibilities and job description for the Director, Quality Management position at Phoenix American Medical, LLC?
Quality Improvement Director
Location: Hybrid (In‑Office & Remote)
Summary
The Quality Improvement Director is responsible for leading, coordinating, and evaluating all continuous quality improvement and organizational excellence initiatives across the company. This role focuses on quality of care, quality of service, HEDIS, 5‑Star performance, NCQA accreditation, and provider/member satisfaction. The Director ensures regulatory compliance while driving organizational improvement strategies across all departments.
Required Qualifications
- Must be an active LPN or RN (required)
- NCQA experience required
- Managed care experience required
- Hybrid schedule — in‑office work required with some remote flexibility
- Minimum 5 years of quality, compliance, or managed care experience (Medicare strongly preferred)
- Bachelor’s degree preferred; Master’s degree a plus
Essential Duties & Responsibilities
- Lead implementation, monitoring, and evaluation of the Quality Management and Organizational Excellence programs.
- Ensure compliance with all regulatory requirements, accreditation standards, and organizational goals.
- Oversee quality programs and support plan‑wide communication and understanding of quality initiatives.
- Serve as Project Director for HEDIS, NCQA, CAHPS, HOS, and other survey/quality programs.
- Develop, interpret, and analyze quality improvement studies, data trends, and performance indicators.
- Support development of provider and member satisfaction improvement plans.
- Work collaboratively with physicians, healthcare providers, and cross‑departmental teams to meet quality goals.
- Coordinate activities for QMSC, MAC, and other quality‑related committees.
- Prepare, support, and manage regulatory and accreditation survey requirements.
- Implement and monitor corrective action plans, ensuring timely and effective completion.
- Provide leadership in promoting organizational excellence, benchmarking, and best practices.
- Participate in market development and due‑diligence activities as assigned.
- Provide oversight and evaluation of delegated services.
Supervisory Responsibilities
- Interview, hire, train, and oversee staff.
- Manage daily operations, assign duties, and provide ongoing feedback.
- Conduct performance evaluations and support staff development.
- Resolve department issues professionally and in compliance with organizational policies.
Competencies
The ideal candidate demonstrates excellence in:
- Analytical thinking & problem solving
- Project management & technical expertise
- Leadership, change management, and team motivation
- Customer service & communication (written and verbal)
- Quality management, strategic planning, and organizational support
- Professionalism, adaptability, and dependability
Education & Experience
- Bachelor’s degree preferred; Associate’s degree with 5 years experience accepted
- Master’s degree is a plus
- Managed care experience required
- Strong knowledge of Medicare and regulatory programs preferred
Additional Requirements
- Expert proficiency in Microsoft Office (Excel, Word, Access, Outlook, Internet Explorer)
- Ability to travel as needed
- Strong analytical, communication, and leadership skills
- Ability to work in a fast‑paced environment while meeting deadlines
Physical & Work Environment
- Must be able to talk or hear regularly; occasional lifting up to 10 lbs.
- Work environment is typically quiet and office‑based.
Job Type: Full-time
Pay: From $100,000.00 per year
Schedule:
- Monday to Friday
Work Location: Hybrid remote in Spring Hill, FL 34606
Salary : $100,000