Director, Quality Informatics

Date: Nov 24, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 8046 

 

Position Summary/Position

 

At Inland Empire Health Plan (IEHP), we believe the highest quality of care should be delivered to all in the Inland Empire.  We are thinking beyond the way Quality is viewed today – we believe it should be holistic and transformative.  
Under the general direction of the Senior Director, Quality Systems, the Director of Quality Informatics is responsible for ensuring compliant, accurate and timely health plan quality reporting in the areas of Healthcare Effectiveness Data and Information Set (HEDIS), Consumer Assessment of Healthcare Providers and Systems (CAHPS) and other health plan quality performance measures. These activities must be compliant with Centers for Medicare and Medicaid Services (CMS), Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC) and National Committee for Quality Assurance (NCQA) reporting and auditing requirements. The Director of Quality Informatics is also responsible for ensuring maximal and effective use of all health plan data sources to support IEHP’s goals of reporting the highest and most accurate ratings. Responsibilities also include monitoring, oversight, and evaluation of IEHP HEDIS, CAHPS and health plan quality activities, with a goal of continuous improvement and goal achievement. This position is responsible for leading analytics and informatics teams that support IEHP's Pay for Performance and other Value Based Payment programs with an annual budget exceeding $248 million.

Major Functions (Duties and Responsibilities)

 

HEDIS/CAHPS
1. Ensure compliance with all regulatory required quality measures, as mandated by CMS, DHCS, NCQA requirements for HEDIS®, CAHPS® and HOS® reporting.
2. Ensure maximal and effective use of all health plan data sources to support IEHP’s goals of reporting the highest and most accurate ratings.
3. Direct HEDIS and CAHPS Improvement activities, ensuring timely and effective completion of IEHP’s planned interventions, including effective evaluations.
4. Serve as Audit Lead on all HEDIS Reporting audits. Collaborate with other IEHP departments to prepare for and comply with required HEDIS compliance audits.
5. Direct the evaluation of HEDIS and CAHPS Improvement activities using valid statistical methods and effectively communicate findings to influence/direct future intervention strategies.
6. Develop strategic internal partnerships with key stakeholders including Health Services, Provider Services, Information Technology, Marketing and Finance departments, as well as external partnerships with Provider groups to meet the needs of the HEDIS, CAHPS and other quality improvement efforts.
7. Direct the Quality Informatics Unit staff to ensure high productivity and high-quality output.

Major Functions (Duties and Responsibilities) Cont

Supervisory Responsibilities

Leader: Administers Hires, Terminations, and Performance Reviews

Experience Qualifications

 

Significant experience (5+ years) in health care research and study design, implementation, and reporting in medical areas. Five (5) years of experience in HEDIS Health Plan reporting. Proven leadership experience, mentoring, and developing a team at a leadership level required.

Preferred Experience

 

Experience working in a health plan system preferred.

Education Qualifications

 

Bachelor’s degree in a related field with emphasis in research design and analytical techniques from an accredited institution required. 

Preferred Education

 

Masters degree in a related field with emphasis in research design and analytical techniques from an accredited institution preferred.

Professional Certification

Professional Licenses

Drivers License Required

Yes, must have a valid California Driver's license and valid automobile insurance. Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points.

Knowledge Requirement

 

Research design and project management. Analytical techniques with emphasis on database design and manipulation, complex query design, spreadsheets, statistical program use and problem solving. Understanding and sensitivity to a multi-cultural environment and community. 

Skills Requirement

 

Must have proficiency in Microsoft Access, Word processing, and SAS, SPSS, or other statistical packages. Excellent writing, interpersonal communication, and organizational skills

Abilities Requirement

 

Must have a high degree of patience. Attention to detail.

Commitment to Team Culture

 

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions

 

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; and taste or smell. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.

Work Model Location

Hybrid

Physical Requirements

Hearing: One-on-One - FREQUENTLY
Communicate: Information/ideas verbally - FREQUENTLY
Near Visual Acuity - FREQUENTLY
Regular contacts: co-workers, supervisor - FREQUENTLY
Memory - FREQUENTLY
Understand and follow direction - FREQUENTLY
Regular and reliable attendance - CONSTANTLY
Keyboarding: 10-Key - FREQUENTLY
Keyboarding: Touch-Screen - FREQUENTLY
Keyboarding: Traditional - FREQUENTLY
Sitting - CONSTANTLY
Indoors - FREQUENTLY
Lighting - CONSTANTLY

 

Starting Salary: $168,584.00  - $223,371.20  

Pay rate will commensurate with experience

 

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region. With a provider network of more than 7,000 and a team of more than 2,500 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.

 


Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles