Job Description:
The Director, Quality Operations is a strategic and operational leader responsible for the accuracy, completeness, and integrity of the data that drives Cityblock's performance on contracted quality measures. This leader ensures we have the most complete picture of member gaps in care and that our data is validated before it is sent to partners, so our performance is accurately and fully reflected. The role also owns data governance for membership-related information and processes for Cityblock contracts.
Responsibilities
- Serve as Cityblock's HEDIS subject matter expert, with deep knowledge of HEDIS measure specifications, data sources, and reporting requirements.
- Lead Cityblock's HEDIS audit readiness and participation, including audit preparation, documentation, and response.
- Drive data completeness and accuracy across systems, identifying and closing data gaps so that performance is accurately reflected before data is submitted to partners.
- Own the management and ongoing optimization of Cityblock's third-party HEDIS engine, which ingests data and reports on our performance. This includes data inputs, validation of outputs, and engine configuration and workflows.
- Maintain a complete, accurate view of member gaps in care, partnering with market, clinical, and operations teams so that gap closure is supported by reliable data.
- Lead and develop a small team of Managers and Senior Associates
- Evaluate system and workflow processes to find and fix root causes of data quality issues, and provide training to the teams involved.
- Collaborate across clinical and non-clinical teams (operations, technology, compliance, finance) and with market teams to implement enterprise-wide initiatives that support contracted quality measure performance.
Requirements
- Master's-level education or work in a healthcare field (MHA, MBA, or MPH) required; clinical experience a plus.
- 7+ years of experience in a healthcare setting (provider, hospital, value-based care, consulting, or health plan) working with quality reporting and operations, alongside care teams.
- Demonstrated HEDIS expertise, including understanding of HEDIS data and hands-on experience going through HEDIS audits.
- Proficiency in Excel and Google Sheets for data manipulation. Experience with coding languages is a plus.
- Experience improving data completeness and accuracy to support quality performance reporting.
- Experience working with HEDIS engines
We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company’s equity program, paid time off, including vacation and sick leave. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location. The expected salary range for this position is:
$125,000.00 - $165,000.00 Annual
Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.
