We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, andinnovate.Webelieve that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways.

At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today!

This job is responsible for developing, managing and integrating a comprehensive approach through cross-functional organizational teams to improve STAR ratings, including upcoming changes to HEDIS, HOS, CAHPS, and health equity and how they influence overall STAR performance. Works in collaboration with Hedis team and responsible for customized action plans focusing on enhancing performance in key areas impacting STAR ratings such as disenrollments, appeals, provider network and member experience. Required to develop frameworks, analytic platforms, tools and/or models for consistently analyzing, interpreting, and extracting data relevant to Star Ratings. Integrates diverse data sources to gain a comprehensive view of the population by combining health data with SDOH, demographic and behavioral data. Development of concrete blueprints outlining steps for implementing change, based on problem-solving sessions and strategic planning across the organization, including medical management teams. This should include process improvement initiatives, technology adoption plans, or patient engagement strategies. Development of comprehensive reports or studies comparing the organization's performance against industry standards or competitors. Applies methodologies like the PDSA cycle for implementing strategic initiatives and continually refining these processes based on results and feedback. The Director will independently make decisions that could seriously affect the overall and strategic results.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.

This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.

Education

Required - Bachelor's degree in Nursing, Public Health, Business Administration, or related fields.

Preferred - Master's degree in Nursing, Public Health, Business Administration, or related fields.

Work Experience

Required - 10 years' experience in healthcare leadership; Experience with healthcare quality, relational databases, and systems analysis; Experience with robust process improvement; Experience with documentation effectiveness tools (Crimson, Truven, 3M, Tableau, Vizient CDB) and analysis of ICD-10-CM data relating to externally reported quality methodologies including AHRQ PSI and CMS HAC.

Certifications

Preferred - Active Certified Professional in Healthcare Quality (CPHQ) certification.

Knowledge Skills and Abilities (KSAs)

• Effective verbal and written communication skills and the ability to present information clearly and professionally.
• Strong interpersonal and conflict resolution skills.
• Proficiency in using computers, software, and web-based applications.
• Analytical skills and ability to use a logical process to formulate practical solutions.
• Strong decision-making, delegation, and leadership skills and the ability to demonstrate good judgement.
• Excellent time management skills and self-direction.
• Maintains and enhances professional competency.

Job Duties

• Develops, manages, and integrates a comprehensive, system quality and performance improvement program that supports system quality strategic initiatives.
• Manages and continuously evaluates improvement of key performance indicators.
• Monitors progress on strategic plans and recommends updates to senior executive quality leaders.
• Serves as a system quality and performance improvement partner to service line leaders and division quality leaders.
• Manages documentation effectiveness program that engages HIM, IS, quality, and physician leaders in improvement strategies associated with clinical documentation.
• Develops personnel and workforce.
• Participates in long strategic planning that supports the company mission.
• Performs other related duties as assigned.

The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time.

Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.

This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns. The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.

Physical and Environmental Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Light Work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible.

Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid.

The incumbent has no occupational risk for exposure to communicable diseases.

Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.

#LI-SF1

Are you ready to make a difference? Apply Today!

Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website.

Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado, California, Washington, New York, and Washington D.C.

Ochsner Health endeavors to make our site accessible to all users. If you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please contact our HR Employee Solution Center at 504-842-4748 (select option 1) orcareers@ochsner.org. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.

We are proud to be an Equal Employment Opportunity and Affirmative Action employer. We are committed to the principles of equal employment opportunity and providing a workplace that is free from discrimination based on race, color, creed, religion, pregnancy status, pregnancy-related conditions, national origin, ancestry, mental or physical disability, medical condition, age, veteran status, military status, citizenship status, marital status, familial status, sexual orientation, gender, gender identity or expression, genetic information, political affiliation, unemployment status, or any other characteristic protected under applicable federal, state or local law. These protections extend to applicants and all employment related decisions. View theEEO is the Law posterand itssupplement, as well as thepay transparency policyfor more information.

Affirmative Action Policy Statement

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, andinnovate.Webelieve that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways.

At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today!

This job is responsible for developing, managing and integrating a comprehensive approach through cross-functional organizational teams to improve STAR ratings, including upcoming changes to HEDIS, HOS, CAHPS, and health equity and how they influence overall STAR performance. Works in collaboration with Hedis team and responsible for customized action plans focusing on enhancing performance in key areas impacting STAR ratings such as disenrollments, appeals, provider network and member experience. Required to develop frameworks, analytic platforms, tools and/or models for consistently analyzing, interpreting, and extracting data relevant to Star Ratings. Integrates diverse data sources to gain a comprehensive view of the population by combining health data with SDOH, demographic and behavioral data. Development of concrete blueprints outlining steps for implementing change, based on problem-solving sessions and strategic planning across the organization, including medical management teams. This should include process improvement initiatives, technology adoption plans, or patient engagement strategies. Development of comprehensive reports or studies comparing the organization's performance against industry standards or competitors. Applies methodologies like the PDSA cycle for implementing strategic initiatives and continually refining these processes based on results and feedback. The Director will independently make decisions that could seriously affect the overall and strategic results.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.

This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.

Education

Required - Bachelor's degree in Nursing, Public Health, Business Administration, or related fields.

Preferred - Master's degree in Nursing, Public Health, Business Administration, or related fields.

Work Experience

Required - 10 years' experience in healthcare leadership; Experience with healthcare quality, relational databases, and systems analysis; Experience with robust process improvement; Experience with documentation effectiveness tools (Crimson, Truven, 3M, Tableau, Vizient CDB) and analysis of ICD-10-CM data relating to externally reported quality methodologies including AHRQ PSI and CMS HAC.

Certifications

Preferred - Active Certified Professional in Healthcare Quality (CPHQ) certification.

Knowledge Skills and Abilities (KSAs)

• Effective verbal and written communication skills and the ability to present information clearly and professionally.
• Strong interpersonal and conflict resolution skills.
• Proficiency in using computers, software, and web-based applications.
• Analytical skills and ability to use a logical process to formulate practical solutions.
• Strong decision-making, delegation, and leadership skills and the ability to demonstrate good judgement.
• Excellent time management skills and self-direction.
• Maintains and enhances professional competency.

Job Duties

• Develops, manages, and integrates a comprehensive, system quality and performance improvement program that supports system quality strategic initiatives.
• Manages and continuously evaluates improvement of key performance indicators.
• Monitors progress on strategic plans and recommends updates to senior executive quality leaders.
• Serves as a system quality and performance improvement partner to service line leaders and division quality leaders.
• Manages documentation effectiveness program that engages HIM, IS, quality, and physician leaders in improvement strategies associated with clinical documentation.
• Develops personnel and workforce.
• Participates in long strategic planning that supports the company mission.
• Performs other related duties as assigned.

The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time.

Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.

This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns. The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.

Physical and Environmental Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Light Work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible.

Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid.

The incumbent has no occupational risk for exposure to communicable diseases.

Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.

#LI-SF1

Are you ready to make a difference? Apply Today!

Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website.

Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado, California, Washington, New York, and Washington D.C.

Ochsner Health endeavors to make our site accessible to all users. If you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please contact our HR Employee Solution Center at 504-842-4748 (select option 1) orcareers@ochsner.org. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.

We are proud to be an Equal Employment Opportunity and Affirmative Action employer. We are committed to the principles of equal employment opportunity and providing a workplace that is free from discrimination based on race, color, creed, religion, pregnancy status, pregnancy-related conditions, national origin, ancestry, mental or physical disability, medical condition, age, veteran status, military status, citizenship status, marital status, familial status, sexual orientation, gender, gender identity or expression, genetic information, political affiliation, unemployment status, or any other characteristic protected under applicable federal, state or local law. These protections extend to applicants and all employment related decisions. View theEEO is the Law posterand itssupplement, as well as thepay transparency policyfor more information.

Affirmative Action Policy Statement