Partnership HealthPlan of California

Senior Director of Quality & Performance Improvement

Job Locations US-CA-Fairfield | US-CA-Redding
Job ID
2025-3754
FLSA Status
Exempt
Hiring Range
$216,303.00 - $302,824.20

Overview

The Senior Director of Quality and Performance Improvement is a key individual on PHC’s
Senior Leadership Team and is responsible for leading a growing Quality Department at
Partnership HealthPlan of California (PHC) through quality and performance improvement
activities to substantially improve the quality of care provided to PHC members.

Responsibilities

  • In collaboration with the CMO, lead the strategic direction of PHC’s quality initiatives
    organization-wide, including prioritization of efforts.
  • Lead, develop, and coach the Quality and Performance Improvement staff including staff
    hiring, training, performance appraisals, goal setting, and resource allocation. Assess
    overall performance using internal and external feedback mechanisms to actively
    optimize capacity within the department while leveraging individual strengths and
    nurturing career development plans.
  • Manage the Quality and Performance Improvement budget.
  • Oversee PHC’s quality improvement program, ensuring all interventions are measured
    for effectiveness and efficiency, complete annual review and update of the program, and
    write annual plan.
  • In collaboration with the CMO and CFO, oversee the administration of PHC’s pay for
    performance programs.
  • Oversee performance improvement activities conducted by the quality department,
    including PHC’s Partnership Improvement Academy, DCHS mandated improvement
    work, performance improvement and engagement activities done with the PHC network.
  • Oversee Quality department activities key to the success of inter-departmental quality
    initiatives and the achievement of organization-wide quality goals.
  • Oversee PHC’s provider level quality data visualization and analysis program, the
    Partnership Quality Dashboard.
  • Oversee the monitoring and improvement activities surrounding PHC’s “Internal Quality
    Dashboard” also known as the PHC Stars, to evaluate and monitor the quality of care
    provided to PHC members.
  • Prepare the organization for quality and performance improvement review, survey, and
    accreditation processes by external monitoring agencies, such as DHCS, DMHC, CMS,
    or NCQA.
  • Oversee the optimization of monitoring systems for collection and reporting of HEDIS
    data, including the statewide improvement projects aimed at improving performance in
    HEDIS measures.
  • Oversee the Facility Site Review/Medical Record review to ensure that all regulatory and accreditation requirements are met within required timeframes and that results are coordinated with the peer review/credentialing/re-credentialing process.


Secondary Duties and Responsibilities

  • Present project updates and results to PHC’s leadership team, internal improvement
    committees, physician committees, and PHC’s Board of Commissioners as appropriate.
  • Oversee the coordination of QI activities and data collection for PHC’s contracted
    medical groups and providers.
  • Organize and prepare all materials and serve as staff resource for assigned PHC
    committees.
  • Work with assigned committees to identify barriers and design intervention strategies
    for quality and performance improvement.
  • Write, review, and seek approval for policies and procedures, ensuring that both the
    departmental and organizational needs are met.
  • Participate in special projects and assignments as required.

Qualifications

Education and Experience

Bachelor’s degree in applicable field required; Master’s degree
preferred. Formal certification in areas of professional expertise such as
Lean Six Sigma, IHI’s Improvement Advisor Program, and training in
the Model for Improvement is desirable. Minimum of five (5) years
management experience in a medium to large size organization.
Experience should include managing multifaceted quality and
performance improvement projects. Working knowledge of principles
and techniques of effective management, including training and
evaluation. In depth knowledge of Quality Improvement
Methodologies. Grant writing and grant management experience is
desirable.

Special Skills, Licenses and Certifications

Demonstrated skills in effectively delegating and meeting deadlines.
Experience in respectful communication with physicians and other
providers. Superior communication skills, adaptability, openness to
feedback and new ideas. Excellent project management skills,
including project planning, resource allocation, and completion status
tracking and reporting. Strong critical thinking and data analytic skills
are required. Advanced data analytic skills are desired. High level of
proficiency in MS Word, Excel, Outlook, and Visio are minimum
requirements. Proficiency in MS Access, MS Project, and reporting
software desirable. Valid California driver’s license and proof of
current automobile insurance compliant with PHC policy are required
to operate a vehicle and travel for company business.

Performance Based Competencies

Enthusiastic, team player, who is an eager learner and driven to
excellence. Ability to lead and motivate teams and motivate superior
performance and the professional development of subordinate staff.
Listening skills and conflict resolution skills. Ability to hire excellent
staff best suited to each job opening. Ability to creatively approach
systems development and improvement, and function independently
while managing multiple priorities. Ability to plan, implement, and
report on quality management activities; prepare clear and concise
reports; maintain proper documentation and confidentiality.
Knowledge of healthcare Quality Improvement, including HEDIS
technical specifications, HEDIS compliance audit process, and other
NCQA standards; and healthcare safety net and how clinical practices
function is desirable. Knowledge of improvement methodologies such
as Lean Six Sigma and/or Model for Improvement and PDSA cycles is
required.

Work Environment And Physical Demands

Must be able to work in a fast paced environment and maintain
courtesy and composure when dealing with internal and external

customers. Ability to function effectively with frequent interruptions
and direction from multiple team members.

 

 

All HealthPlan employees are expected to:

 

  • Provide the highest possible level of service to clients;
  • Promote teamwork and cooperative effort among employees;
  • Maintain safe practices; and
  • Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

HIRING MANAGER:

 

$216,303.00 - $302,824.20

 

 

IMPORTANT DISCLAIMER NOTICE

 

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

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