Director, Medicaid Outreach & Quality

Job Summary

The Director, Health Plan Quality Improvement, is responsible for creating a culture of quality throughout the organization. Accountable for quality improvement work both internal and external to the enterprise, this role provides critical leadership around the design, implementation, and evaluation of innovative projects aimed at improving the health outcomes of populations.

Essential Functions

• Leads cross functional team (clinical, business analytics, quality, etc.) responsible for quality

• Lead key quality improvement initiatives/projects external to Priority Health

• Collaborates with the provider engagement team to ensure providers are an activated population to influence quality and to provide the services necessary to maximize the quality results

• Serves as Priority Health Choice’s representative on MDHHS’s Quality Committee. Attends other State and Michigan Association of Health Plan meetings as appropriate. Represents Priority Health externally in the area of quality improvement

• Influence officials, policy makers, program directors to advance quality measures, and other criteria, that will improve Priority Health’s position in regards to the quality bonus, consumer guide, and auto assignment algorithm.

• Provide leadership and direction for VBC and PIP work on quality related matters

Qualifications

• Required Bachelor's Degree or equivalent Business, Marketing, Public Health, Medical

• 5 years of relevant experience Management Required

• 5 years of relevant experience Managed Care, strategic planning, project management, population health.

• Broad experience in directing and getting work done through others. Proven ability to effectively lead cross-functional teams and build processes to deliver results. Required

Physical Demands

• Bilateral Carry > 5 lbs: Seldom up to 10 lbs

• Unilateral Carry > 5 lbs: Seldom up to 10 lbs

• Pushing Force > 5 lbs: Seldom up to 10 lbs

• Pulling Force > 5 lbs: Seldom up to 10 lbs

• Sitting: Frequently

• Standing: Occasionally

• Walking: Occasionally

• Forward Bend - Standing: Seldom

• Forward Bend - Sitting: Occasionally

• Trunk Rotation - Standing: Seldom

• Trunk Rotation - Sitting: Occasionally

• Reach - Above Shoulder: Seldom

• Reach - at Shoulder or Below: Seldom

• Handling: Occasionally

• Forceful Grip > 5 lbs: Seldom

• Forceful Pinch > 2 lbs: Seldom

• Visual Acuity ¹

• [None = No; Seldom = Yes]: Seldom

How Corewell Health cares for you

• Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.

• On-demand pay program powered by Payactiv

• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!

• Optional identity theft protection, home and auto insurance, pet insurance

• Traditional and Roth retirement options with service contribution and match savings

• Eligibility for benefits is determined by employment type and status

Primary Location

SITE - Priority Health - 1239 E Beltline - Grand Rapids

Department Name

PH - Population Health and Health Equity Leadership

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

40

Days Worked

5

Weekend Frequency

Variable weekends

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Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to