Director of Quality

Description

The Director of Quality is responsible for developing, implementing, and maintaining a comprehensive Quality Improvement (QI), Population Health, and performance management program for the Joseph P Addabbo Family Health Center, (JPAFHC). This role provides strategic oversight of quality and population health initiatives, including proactive patient outreach, care gap identification and closure, performance improvement, and population health management, to improve clinical outcomes and patient engagement.

The Director oversees the Population Health function and collaborates with clinical, care management, analytics, and operational teams to ensure effective implementation of population health strategies and achievement of organizational performance goals. The role ensures compliance with HRSA requirements, NCQA Patient-Centered Medical Home (PCMH) standards, UDS reporting, HEDIS measures, and other applicable regulatory and accreditation requirements, while fostering a culture of data-driven decision-making, continuous improvement, and accountability for clinical, operational, and patient experience outcomes.

Requirements

RESPONSIBILITIES:

• Directly supervise the Quality Assurance Coordinators.
• Develop, review, and update Quality Assurance policies and procedures to support consistent implementation of quality standards and continuous improvement initiatives.
• Serves as the primary liaison between JPAFHC and Managed Care Organizations (MCOs), representing the organization in all quality-related engagements and ensuring active participation in MCO quality meetings.
• Proficiency with the Azara platform to support clinical team utilization, pre-visit planning, and care transition workflows.
• Lead collaboration with the IPA to drive quality performance and achieve value-based contract deliverables and targets.
• Utilize data stratification and risk adjustment tools to identify high-risk patients, prioritize interventions, and support targeted population health initiatives.
• Ensure continued annual recognition and compliance with NCQA Patient-Centered Medical Home (PCMH) standards and requirements.
• Assesses patient medical records to ensure compliance with established quality standards.
• Coordinates and ensures timely completion of the quarterly provider peer review cycle.
• Conduct on-site visits to monitor and assess the implementation of QA/QI activities, including pre-visit planning and daily huddles.
• Aggregates statistical quality assurance data, develops comprehensive narrative reports, and partners with clinical informatics specialists to support data-driven improvements.
• Collaborate with the CMO to revise the Quality Assurance and Utilization Review plan in accordance with HRSA guidelines.
• Coordinates recurring QI/QA committee meetings with the Quality Coordinators and Department Leads, manages meeting coordination, records minutes, tracks participation, and ensures timely follow-up on all assigned tasks and activities.
• Monitor and track performance on HEDIS and other quality measures across payer contracts.
• Develop and implement strategies to close care gaps, including outreach campaigns, provider engagement, and patient education.
• Maintain up-to-date knowledge of CMS, NCQA, and payer-specific quality measure requirements.
• Collaborate with clinical teams, payors, and population health staff to align quality improvement efforts with value-based care goals.
• Assist in the reporting and analysis of quality metrics to identify trends, disparities, and opportunities for improvement.
• Collaborate with IT and analytics teams to ensure accurate and timely data capture, reporting, and maintenance of clinical dashboards.
• Support audit readiness by preparing, compiling, and organizing documentation and supporting evidence for HEDIS audits and external reviews.
• Contribute to quality improvement initiatives, such as PDSA cycles, root cause analyses, and performance dashboards.

May be required to perform other duties as assigned or when necessary.

QUALIFICATIONS

Education:

Bachelor’s degree in healthcare administration, public health, Nursing, or related field required.Master's degree in public health, Healthcare Administration, or related field preferred.

A licensed Registered Nurse (RN) or Nurse Practitioner (NP) with a strong background in healthcare quality improvement will also be considered in lieu of a master’s degree.

Experience:

Minimum 5 years of progressively responsible experience in healthcare quality or performance improvement, preferably in a community health center or FQHC setting.

Strong working knowledge of HRSA, UDS, NCQA PCMH, and related regulatory requirements.

Skills:

• Demonstrated ability to lead quality initiatives and manage cross-functional teams.
• Proficiency in data analysis and quality improvement tools (e.g., Excel, EHR reporting, QI methodologies).
• Demonstrated ability to drive proactive outreach strategies to increase annual physical completion rates among MCO-attributed patients and improve preventive care outcomes.
• Excellent verbal and written communication skills.
• Experience with risk management, clinical compliance, and patient safety programs is a plus.

Working Conditions:

Primarily office-based with some travel between clinical sites.

May require occasional evenings or weekends for meetings or training.