Sr. Director/Director, Quality Program Management & Performance

A recent study shows that men apply for a job or promotion when they meet only 60% of the qualifications, but women and other marginalized groups apply only if they meet 100% of them. So, if you think you'd be a great fit, but don’t necessarily meet every single requirement on one of our job openings, please still apply. We’d love to consider your application!

At Wayspring, we are committed to furthering our value of Equity & Inclusion throughout our recruiting practices. We seek diversity of background and opinion, as we think these attributes improve the performance of our company and are the right thing to do for our communities. We recognize and remove barriers to success within our company and communities. We seek to build a recruiting process that is inclusive and fosters diversity.

Overview of the Senior Director/ Director, Quality Program Management & Performance

The Senior Director/Director, Quality Program Management & Performance influences and provides clinical quality subject matter expertise to direct the quality improvement program and activities. The Director works within highly matrixed relationships to lead and develop the overall quality strategy for the Company, ensuring the quality program is proactive, continuously improving to include quality management/improvement, and supporting the oversight of clinical quality regulatory and NCQA guideline adherence. The incumbent provides insight and direction to the Company to align with a changing healthcare landscape as it applies to quality.

The Director is a population health expert for Waypsring and assesses the markets and gaps in programs and disparities, proactively communicating the needs, and assisting to drive innovation to find programs that work at the market level with the population. The incumbent understands and influences the member engagement and provider engagement programs and assures oversight to close gaps in care and improve clinical outcomes for members.

Responsibilities of the Senior Director/Director, Quality Program Management & Performance

• Collaborate with operations teams to plan, implement, and manage population health and clinical operations programs and services
• Monitor and evaluate clinical operation services and employee performance
• Provide leadership and strategic direction to management and the functional business units on strategies for health care/SDoH gap closure
• Ensure regulatory and accreditation standard compliance of clinical operations programs and services; responsible for successful NCQA accreditation evaluation, if pursued organizationally.
• Drives programs and initiatives to assure member access to care and gaps in care closure
• Displays innovative problem solving and upholds principles of continuous quality improvement
• Serves as a subject matter expert in quality management, NCQA/other accreditation standards, HEDIS, CAHPS, CMS, and other regulations and guidelines
• Assists in driving a business culture that centers on collaboration and performance and that continually enhances employee engagement
• Monitors, daily, weekly, monthly, quarterly, semi-annual, and annual reports against goals to assess program success and alignment and to identify opportunities for improvement
• Accountable for annual trilogy documents including the Quality Management Work Plan, Program Description, and Annual Evaluation
• Accountable for quarterly Quality Management Committee meetings to support quality oversight of programs and services
• Meet annual goals, objectives, and key metrics in conjunction with Operations and Health Services teams
• Adhere to Wayspring information security and privacy requirements

Requirements

• BA/BS degree in health care related field or equivalent experience
• Clinical background (e.g. RN, nurse practitioner, pharmacist, MSW, etc.)
• Minimum of 7 years experience in managed care or a healthcare delivery system
• Minimum of 5 years experience in progressive leadership and managerial experience
• Subject matter expertise in clinical quality, accreditation, health plan operations, utilization management, population health management, provider practice management, regulatory requirements, etc.
• Experience in completing clinical quality studies
• Ability to work independently with minimal supervision
• Ability to work effectively in a complex and highly matrixed environment
• Superior verbal and written communication skills, ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand as well as the ability to understand and interpret complex information from others
• Ability to work in a fast-paced environment and multi-task
• Strong analytical and relationship management skills
• Advanced skills with Excel and PowerPoint
• Performance-driven and a team player
• Limited travel required
• Advanced degree (preferred)
• Certified Professional in Healthcare Quality (preferred)

Company and Benefit Summary

Wayspring has reimagined substance use disorder treatment. We provide individualized care, delivered with a peer-centered approach. We focus on making sure patients have their basic needs met, like access to care, economic stability, and connection to relationships and community. Then we help each person find their own way to wellness.

• Hybrid In-Office/WFH options for the Nashville Office - other markets are fully remote!
• Medical, Dental, and Vision Insurance Options
• Company funded HSA
• Monthly Gym Allowance
• Paid parental leave – all parents included!
• Company-paid short term disability, long term disability, and life insurance
• Generous 401k match
• Premium Employee Assistance Program, inclusive of counseling sessions
• Company Contributions to Future Minded Savings (think 529, HSA, Student Loan Reimbursement, and Emergency savings fund)
• Generous PTO package (accrual policy based on years of service) and an additional 10 paid Company holidays

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Professional development assistance
• Retirement plan
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Supplemental Pay:

• Bonus pay

Application Question(s):

• I understand some Wayspring partners may have a COVID-19 vaccination policy. Because of this, I understand some Wayspring positions may require proof of COVID-19 vaccination. I agree to adhere to this policy and understand it is enforced in compliance with applicable federal, state, and local laws.

License/Certification:

• Clinical License (Preferred)

Work Location: Multiple Locations