At Banner Health, we believe that “leadership matters” and is a key component to providing excellent patient care. Join a nationally recognized leader that values excellence, and begin making a difference in people’s lives.
As a Quality Director of the Insurance Division, there will be exciting opportunities to be part of the health care transformation. We are known nationally as an innovative leader in new health care models, where insurance plans and physicians come together to work collaboratively to make things easier for the member. The division serves over 500,000 members in our community.
Opportunities to work 1/2 days remote
525 W Brown RD
Mesa, AZ 85201
Your pay and benefits are important components of your Journey at Banner Health. This opportunity is also eligible for our Management Incentive Program, as part of your Total Rewards package. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.
About Banner Health Network & Banner Plan Administration
Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.
About Banner Health
Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.
The primary purpose of this position to provide vision, leadership and direction in the development, implementation and evaluation of The University of Arizona Health Plans Quality Program. The Director of Quality Management will provide oversight for program development, program implementation, and program compliance. Areas of responsibility include: oversight of Performance Measures and the design of strategies to improve performance, oversight of Quality of Care processes, oversight of the HEDIS reporting and the NCQA Structure and Process Measures, and responsibility for all reporting to the QM/PI Committee. The Director of Quality will supervise the Credentialing department.
Required for successful performance in this position is a Bachelors degree in Nursing, with a current licensure as a registered nurse in the State of Arizona, or a Masters degree and Certified Professional in Healthcare Quality (CPHQ) by the National Association for Health Care Quality (NAHQ) and/or Certified in Health Care Quality and Management (CHCQM) by the American Board of Quality Assurance and Utilization Review Providers. Director level experience in healthcare management, with at least five years of experience in a quality/utilization management leadership role, is required.
Direct experience overseeing quality improvement processes and knowledge of the requirements of national/state accrediting agencies, such as NCQA, HEDIS, Medicare (CMS) and Medicaid (AHCCCS) is required. Demonstrated knowledge and experience in the development and implementation of clinical and operational information systems that support staff operations and reporting is needed. Strong analytical skills and data management skills are required. Excellent communication skills are required.
The ability to work in a cross-departmental collaboration model is required. The ability to build consensus and ensure continuous feedback on process and progress is critical. The ability to prepare and deliver presentations is required, as is the ability to recommend realistic courses of action and operational changes as a result of data analysis.
Additional related education and/or experience preferred.