What are the responsibilities and job description for the Director of Quality Assurance position at Provider Resources, LLC?
Position Summary
Reporting to the Program Manager for the Independent Dispute Resolution Entity (IDRE) or their delegate, the Director of Quality Assurance provides strategic leadership and oversight of the Quality Assurance (QA) function across the IDRE program. This role is responsible for developing and executing a comprehensive quality strategy aligned with organizational goals, ensuring compliance with ISO standards, and fostering a culture of continuous improvement. The Director leads a team of QA professionals, collaborates with senior leadership, and serves as a key liaison with external stakeholders to ensure the highest standards of quality and performance.
Key Responsibilities:
Reporting to the Program Manager for the Independent Dispute Resolution Entity (IDRE) or their delegate, the Director of Quality Assurance provides strategic leadership and oversight of the Quality Assurance (QA) function across the IDRE program. This role is responsible for developing and executing a comprehensive quality strategy aligned with organizational goals, ensuring compliance with ISO standards, and fostering a culture of continuous improvement. The Director leads a team of QA professionals, collaborates with senior leadership, and serves as a key liaison with external stakeholders to ensure the highest standards of quality and performance.
Key Responsibilities:
- Lead the design, implementation, and continuous improvement of the enterprisewide Quality Assurance Program.
- Develop and execute strategic quality initiatives that align with organizational goals and regulatory requirements.
- Oversee the development and delivery of training programs and quality improvement tools in collaboration with instructional designers and operational leaders.
- Ensure compliance with ISO standards and lead internal and external audit readiness efforts.
- Analyze quality metrics and trends to inform executive decisionmaking and drive performance improvements.
- Serve as a senior advisor to program leadership on qualityrelated risks, mitigation strategies, and best practices.
- Foster a culture of accountability, transparency, and excellence through coaching, mentoring, and performance management of QA staff.
- Represent the organization in clientfacing quality discussions and regulatory reviews.
- Collaborate crossfunctionally with HR, Compliance, Education & Outreach, and Operations to ensure alignment and integration of quality initiatives.
- Lead remediation efforts and corrective action planning for quality deficiencies.
- Bachelor’s degree in Health Administration, Public Health, or a related field (Master’s preferred).
- Minimum 7 years of progressive experience in quality assurance, with at least 3 years in a leadership or directorlevel role.
- Demonstrated expertise in ISO 9001 or other quality management systems and audit processes.
- Proven ability to lead crossfunctional teams and manage complex quality initiatives in a regulated environment.
- Strong analytical skills with experience using quality metrics to drive decisionmaking.
- Exceptional communication and stakeholder engagement skills, including experience presenting to senior leadership and external partners.
- Experience in dispute resolution, healthcare claims adjudication, or federal healthcare programs is highly desirable.
- Ability to obtain and maintain U.S. Government Security Clearance.
- No adverse actions pending or taken by any State or Federal licensing board or program.
- No conflict of interest as defined in 1154(b)(1) of the Social Security Act.
- Proficiency in Microsoft Office Suite and quality management tools.
- Demonstrated commitment to integrity, confidentiality, and continuous quality improvement.
Salary : $142,000 - $195,000