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Lead Director – Quality Management
CVS Health. Lead development and execution of the Kentucky Medicaid Quality Strategy .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates extensive experience in leading healthcare quality initiatives, regulatory compliance, and performance improvement strategies. Proficient in managing quality metrics, data analysis, and fostering collaboration to enhance member outcomes.
Highest-signal resume keywords
Healthcare Quality ManagementQuality Improvement InitiativesHEDIS ExperienceRegulatory ComplianceLeadership in Healthcare
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Performance Improvement MethodologiesData AnalysisQuality MeasurementMedicaid Quality ProgramsPopulation Health Management
Soft Skills
Analytical SkillsCommunication SkillsExecutive Presentation SkillsCoaching and DevelopmentCollaboration
Industry Keywords
NCQACMSAccreditation StandardsQuality Assurance Performance Improvement (QAPI)Value-Based Care
About the role
Key responsibilities & impact- Lead development and execution of the Kentucky Medicaid Quality Strategy
- Direct quality improvement initiatives focused on regulatory, contractual, and enterprise quality objectives
- Drive performance improvement efforts for HEDIS, QRS, state quality metrics, value-based incentives, and market-specific performance goals
- Provide leadership and oversight for QAPI activities
- Oversee regulatory quality reporting, state deliverables, and Performance Improvement Projects
- Ensure readiness for NCQA, EQRO, CMS, state audits, accreditation activities, and regulatory reviews
- Partner with market and enterprise teams to improve member outcomes and reduce healthcare disparities
- Lead provider performance improvement strategies, including provider engagement, practice transformation, and quality interventions
- Monitor quality performance trends and identify improvement opportunities through data-driven analysis and targeted action plans
- Develop and present executive-level performance reports, recommendations, and strategic updates
- Support enterprise initiatives related to digital quality, interoperability, value-based care, behavioral health, maternal health, preventive care, and chronic condition management
- Provide leadership, coaching, and development for quality team members
- Foster accountability, innovation, continuous improvement, and collaboration
Requirements
What you’ll need- Must reside in the state of Kentucky
- 10 years of experience in healthcare quality, managed care, population health, clinical operations, healthcare administration, or a related field
- 7+ years of leadership experience
- Experience leading quality improvement initiatives and performance management programs
- Knowledge of Medicaid quality programs, regulatory requirements, and healthcare quality measurement
- Experience working with HEDIS, NCQA, CMS, accreditation standards, and performance improvement methodologies
- Demonstrated ability to lead cross-functional initiatives and influence leaders across multiple business areas
- Strong analytical, communication, and executive presentation skills
- Bachelor's degree required
Benefits
Comp & perks- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being
- CVS Health bonus, commission or short-term incentive program
- Equity award program