Senior Director, Quality Ratings & Network Performance

Who we are

Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.

Our commitment is to :

• Strive to apply an equity lens to all our work.
• Reduce health disparities.
• Create an equitable work environment.

About the Role

The Senior Director, Quality Ratings and Network Performance leads strategic initiatives to improve health plan quality ratings and provider performance, with a focus on Medicaid, Exchange, and D‑SNP populations. This role is responsible for collaborating across the organization with other key stakeholders and leaders to drive measurable improvements in official HEDIS, HOS, and CAHPS performance and reporting, as well as execution of provider strategies to drive measurable improvement, while ensuring compliance with state and federal regulatory requirements. Key to success in this role includes bringing a deep expertise in Medicaid and Medicare quality programs, analytic approaches to conducting comprehensive evaluations and outcome measurement of rapid cycle improvement strategies, HEDIS, CAHPS and HOS program management and strategic approaches to optimizing data procurement and reporting, D‑SNP Star program management, and value‑based provider strategies.

To be successful in this role, you :

Essential functions and Roles and Responsibilities :

Quality Ratings Oversight

Provider Network Performance

Leadership & Collaboration

Knowledge, Skills, and Abilities

As part of our hiring process, the following criteria must be met :

Criminal History :

Includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant’s criminal history will be reviewed on a case‑by‑case basis considering the risk to the business, members, and / employees.

Compensation and Benefits :

The position is FLSA Exempt and is not eligible for overtime. Based on market data, this position grade is 74 and has a 15% annual incentive target based on company, department, and individual performance goals.

CHPW offers the following benefits for Full and Part‑time employees and their dependents :

Sensory / Physical / Mental Requirements :

Sensory

Physical

Mental

Work Environment :

Office environment. Employees who frequently work in front of computer monitors are at risk for environmental exposure to low‑grade radiation.

Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review Know Your Rights notice from the Department of Labor.

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