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Job Posting Title

Dir Quality

**Job Description**:
The Director Quality is responsible for leading and executing all services and programs designed to improve key quality related measurements such as NCQA, URAC and population health for both government and commercial sectors. This role leads a quality team in identifying and developing core tools, resources and technology to drive performance quality and collaborates with key internal and external partners and vendors to create innovative offerings that decrease the total cost of care for members and clients.

**Responsibilities**:

- Formulate strategic and tactical plans, processes and tools relative to the highest standards of quality; establish and maintain quality procedures and processes that drive meaningful and measurable results
- Develop, implement, manage and maintain quality systems and technology to support the quality operations
- Work cross-functionally with key internal partners to drive synergies related to quality improvement for Prime’s entire book of business
- Identify new trends and measurement opportunities that impact the future quality strategy and position Prime for growth across all market segments
- Interact with key industry quality leaders and position Prime as a leader in this space through measurable and sustained year over year results
- Lead the department staff, budget, performance and development, and consistently demonstrate Prime’s leadership expectations during interactions with direct reports, cross-functional and external stakeholders
- Other duties as assigned

Minimum Qualifications
- Bachelor’s degree in business, health services or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
- 8 years of work experience in quality assurance, analytics, audit, compliance, operational compliance or related field
- 5 years of leadership/people management experience
- Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications
- Excellent written and verbal communication skills with the demonstrated ability of presenting operational and project updates to senior executives
- Strong organizational, analytical, interpretative, and time management skills
- Strong interpersonal skills including team leadership and collaboration
- Understanding of NCQA, URAC and First Call Resolution programs
- Strong understanding of modern quality philosophies
- Demonstrated ability to identify and develop quality programs

Preferred Qualifications
- Experience working with cross-functional partners both internally and externally
- Experience with analytical tools such as Excel, Access data bases, SaaS

Minimum Physical Job Requirements
- Travel required 25% of time
- Constantly required to sit, use hands to handle or feel, talk and hear
- Frequently required to reach with hands and arms
- Occasionally required to stand, walk and stoop, kneel, and crouch
- Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
- Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Reporting Structure
- Reports to AVP or VP in the Member Operations department

Potential pay for this position ranges from $104,700.00 - $167,300.00 based on location, experience and skills.

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