Assistant Director (AD) - Federal Employee Program (FEP) Quality

Assistant Director (AD) - Federal Employee Program (FEP) Quality and Plan Incentive Performance (PIP)
Teleflex/Onsite Flex Options (No Telecommute/Remote) - Must reside in ID, OR, UT or WA (Tacoma WA Preferred)


WHO WE NEED

The Assistant Director of the FEP Quality & PIP provides direction and leadership for the development, implementation, and management of quality & PIP management functions across all FEP plans (including quality outcomes, quality improvement initiatives, and related PIP and quality compliance functions). Ensures programs and program results meet/exceed business needs, are market competitive, compliant with regulatory standards and designed to improve the quality of service and health care outcomes for members. As part of the FEP Leadership Team establish business objectives, allocate resources, and drives results. Represents FEP Quality & PIP in interactions with all levels of management, supplier partners, government representatives, providers, and outside consultants.



Preferred Key Experience:




Five years of management/leadership experience or equivalent combination of education and experience.

HEDIS/CAHPS measurement and reporting knowledge and experience preferred to drive quality initiatives for the FEP line of business.

Knowledge of FEP quality and PIP requirements and demonstrated ability to manage compliant operations preferred.

Collaborates within FEP and with Clinical staff, Health Informatics, Provider Services, and other departments as needed to drive quality and PIP improvements as well as collect, analyze, and report on metrics and effectiveness of programs.

Leads identification and implementation of quality improvement and population health programs that improve quality and PIP performance (including the evaluation of and contracting with suppliers as needed).


YOUR ROLE


Provides leadership in developing, implementing, and communicating short and long-range plans, goals, and objectives for the FEP Quality & PIP functions. Aligns team goals with the FEP organizations vision and strategy.

Manages the organization by ensuring clear performance expectations along with appropriate skills sets.

Fosters an effective work environment and ensures employees receive recognition, feedback, and development. Participates in organizational talent management and succession planning.

Determines appropriate staffing levels and resource needs, creates, and manages department and/or project budget, allocates resources, and approves expenditures.

Ensures FEP Quality & PIP programs achieve desired outcomes and meet/exceed quality and PIP metrics.

Collaborates within FEP and with Clinical staff, Health Informatics, Provider Services, and other departments as needed to drive quality and PIP improvements as well as collect, analyze, and report on metric and effectiveness of programs.

Leads identification and implementation of quality improvement and population health programs that improve quality and PIP performance (including the evaluation of and contracting with suppliers as needed).

Ensures education and training for leadership and staff and business associates as to the quality management plan and their respective responsibilities.

Represents the FEP organization in a variety of internal and external forums focused on quality improvement.



WHAT YOU BRING




Demonstrates ability to lead high performing teams, manage managers, and direct suppliers.

Strong communication and facilitation skills with all levels of the organization, including the ability to resolve issues and build consensus among groups of diverse stakeholders.

General business acumen including understanding of market dynamics, financial/budget management, data analysis and decision making.

Knowledge of health insurance industry trends and technology.

Knowledge of Quality improvement theory, research design and statistics in the healthcare setting.

Demonstrates ability to create, advocate for and execute FEP Quality & PIP programs that achieve desired outcomes targets and drive performance across internal teams, the delivery system and/or suppliers.

Knowledge of FEP quality and PIP requirements and demonstrated ability to manage compliant operations preferred.

Health Plan Accreditation (NCQA or URAC) and HEDIS/CAHPS measurement and reporting knowledge and experience preferred.

Ability to decipher and interpret quality and PIP data and deliver presentations to various internal/external audiences related to outcomes.


Normally to be proficient in the competencies listed above:

The Assistant Director FEP Quality & PIP would have a Bachelors degree in health care, business or related field, 5-7 years of progressively responsible health care or health insurance experience, 5 years of management/leadership experience or equivalent combination of education and experience.


FTEs Supervised

1-4 direct reports (1 manager, 3 ICs)

Additional Job Description
Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members for 100 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association.

If youre seeking a career focused on making the health care experience simpler, better, and more affordable for people and their families, consider joining our team at Cambia Health Solutions. Cambia is a total health solutions company that is deeply rooted in a 100-year legacy of transforming the industry and the way people experience health care. We had our beginnings in the logging communities of the Pacific Northwest as innovators in helping workers afford health care. That pioneering spirit has kept us at the forefront as we build new avenues to improve access to and quality of health care for the future. Cambia is committed to delivering a seamless, personalized health care experience for the next 100 years.


This position includes 401(k), healthcare, paid time off, paid holidays, and more. For more information, please visit (link removed)/careers/total-rewards.


We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email (e-mail removed) Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy. As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our Careers site.