Director, Quality Management – Medicaid / Medicare


The Director of Quality Management (QM) will lead and direct the efforts of the QM Department staff in the collection, analysis, and reporting of quality data metrics. The Director will facilitate improvement projects, assessing for and implementing risk reduction measures and assessing and coordinating activities related to achieving and maintaining ongoing regulatory compliance. The Director will work collaboratively with clinical leadership staff in support of quality goals and objectives and serves as subject matter expert to ancillary areas by providing strategic improvement plans with a focus on quality operations. Acts as LIBERTY Dental Plan’s pointperson for interactions with regulatory agencies and provides corporate-wide support for quality outcomes and related initiatives as developed and implemented.


Essential Duties:

  • Responsible for the overall department operations, monitoring and compliance of all quality policies and procedures, contractual obligations and URAC activities and performance; determines thresholds for action plans when needed.
  • Provides leadership to quality staff; ensures validity of measurement, accuracy of data, patient safety and regulatory compliance with quality improvement.
  • Facilitates organizational enhancement of quality of care, processing and system improvements, and compliance through comprehensive quality assessment and improvement programs.
  • Oversees the effective development, implementation, and evaluation of the QM Programs, workplans, key performance indicators, planned activities and interventions.
  • Leads a visible and transparent project prioritization process to align resources with initiatives and to ensure interdisciplinary efforts are in support of organizational strategic priorities.
  • Collaborates with quality initiative teams and process innovation to improve care delivery and documentation.
  • Continuously reviews all applicable State and Federal regulations and proposes changes to existing QM policies and procedures, ensuring consistency across all product lines.

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