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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in leading quality management and performance improvement initiatives within healthcare, focusing on HEDIS, Medicare Stars, and regulatory compliance. Proven ability to leverage data analytics for strategic decision-making and enhance member experience and patient safety.
Highest-signal resume keywords
Quality Management LeadershipHEDIS and Medicare Stars ExpertiseData Analytics and Performance ReportingRegulatory Compliance and AccreditationCross-Functional Team Management
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Quality Improvement InitiativesData AnalyticsPerformance MeasurementRegulatory RequirementsQuality Assurance ProgramsOperational EffectivenessClinical Outcomes ImprovementMember Experience EnhancementChange ManagementStrategic Initiative Development
Soft Skills
Analytical Problem-SolvingExcellent CommunicationStakeholder ManagementInfluencing Executive LeadersTeam Leadership and Development
Tools & Technologies
Microsoft Office Suite
Industry Keywords
HealthcareBehavioral HealthAccreditation StandardsQuality MeasuresRegulatory AgenciesMember InsightsPerformance ImprovementPatient SafetyOperational PerformanceContinuous Improvement
About the role
Key responsibilities & impact- Provide strategic leadership for the organization’s quality management, performance improvement, and compliance programs
- Develop and lead the enterprise quality strategy
- Drive improvements in clinical outcomes, member experience, patient safety, regulatory performance, and operational effectiveness
- Partner with clinical, operational, and health plan stakeholders
- Leverage data, member insights, and best practices to deliver sustainable quality improvements
- Advance HEDIS, Medicare Stars, and satisfaction performance
- Establish and oversee quality measurement, reporting, and performance monitoring frameworks
- Translate quality data and performance trends into actionable insights, recommendations, and executive-level reporting
- Support decision-making and continuous improvement initiatives
- Lead quality assurance, improvement, and audit programs
- Ensure compliance with regulatory, accreditation, contractual, and organizational requirements
- Drive risk mitigation, change management, and stakeholder engagement efforts
- Strengthen care quality, patient safety, operational performance, and external partnerships
- Lead, coach, and develop a high-performing team
- Foster accountability, continuous learning, and alignment with organizational values
- Work from home using company-provided equipment
Requirements
What you’ll need- Bachelor’s degree in business, Marketing, Health Administration, or related field
- 8+ years of experience in a member or customer experience role, ideally in a healthcare, tech, or behavioral health environment
- 3+ years in a leadership role managing cross-functional teams
- Strong understanding of behavioral health strategy and concepts
- Experience leading enterprise-wide quality improvement initiatives and driving measurable performance outcomes
- Experience working with health plans, accreditation organizations, regulatory agencies, and clinical stakeholders
- Experience with HEDIS, Medicare Stars, quality measures, accreditation standards, and regulatory requirements preferred
- Experience utilizing data analytics and performance reporting to inform strategic decision-making and quality improvement efforts
- Proficiency in Microsoft Office Suite
- Ability to pass a background check upon hire and throughout employment
- Ability to complete education and employment verification, FACIS Level I screening, a 10-panel drug screening, and E-Verify requirements
- Strong analytical and problem-solving skills
- Ability to translate complex data into actionable insights
- Proven ability to lead organizational change, manage competing priorities, and drive results in a complex healthcare environment
- Excellent communication, presentation, and stakeholder management skills
- Ability to influence executive leaders and cross-functional teams
- Ability to develop and execute strategic initiatives improving clinical quality, member experience, patient safety, and operational performance
- Must work from a quiet home workspace with minimal background noise
- Must have high-speed internet service with minimum download speed of 20 Mbps, upload speed of 5 Mbps, and maximum latency of 100 milliseconds, installed before starting
Benefits
Comp & perks- Annual performance-based, discretionary incentive
- Medical, dental, and vision coverage
- 401(k) with competitive employer match
- Company-paid life and disability insurance
- Paid parental leave and wellbeing incentives
- Generous paid time off, including volunteer time
- Flexible spending accounts for healthcare and dependent care
- Professional development opportunities and tuition reimbursement
- Remote work flexibility (role-dependent)
- Company-provided equipment
- Opportunity for meaningful personal and professional growth