Senior Manager, Accreditation and Quality

The role is responsible for management of the Quality and Accreditation Operations department, its products, and deliverables. Responsible for organization strategy for improving the Quality of Care, Customer Service and Resource Use (QCR) measures, incorporating FEP capacity and Plan needs. Serves as resource to BCBSA and Plans in support of primary division initiatives and accreditor requirements. Provides a vision to continually improve the health of the total FEP membership. Functions as content expert for quality improvement, Plan operations, FEP operations and accreditor standards and operations. Incorporates clinical insights into program development and member communications and provides clinical support to various FEP departments.Provides direction and leadership for the department and manages day-to-day and emerging needs/issues. Keeps current of HEDIS, NCQA, URAC requirements, and translates new standards and measurement requirements to FEP and Plan responsibility tasks. Sets the strategic direction and policies of the accreditation operations team and for QCR improvement. Participates in the development and implementation of tactical programs to improve member care and service and advance the core objectives of the BCBSA. Interacts significantly with high level Plan medical management staff, senior level staff within divisions at the Association, and vendors. Develops supports and artifacts which increase the value of services for Plans and customers.Provides leadership and direction in the implementation of project initiatives to ensure goals are met and to provide value to Plans and customers. Collaborates with cross functional leads. Maintains the FEP accreditation Responsibility Matrices and FEP Accreditation Work Plan. Monitors deliverables from other departments and vendors. Ensures compliance with accreditor standards.Develops presentation content for the FEP National Conference, Business Operations and Technical Conference, the Quality Oversight Group, the HEDIS Improvement Team Town Hall Call and the Accreditation Town Hall Call. Serves as a conduit of information from customers to appropriate BCBSA staff.Development of annual budget and project determinations related to accreditation operations and the Quality Oversight Group. Estimates department staff time for other functional areas. Annually reviews and assures the accuracy of department queries and information in the Plan budgeting process.Lead and manage a team with the aim of driving effective performance management, fostering professional growth, and creating a positive and inclusive work environment. This role is dedicated to utilizing strong leadership and communication skills to motivate and inspire team members, ensuring they are aligned with and committed to achieving the organization’s goals.The posting range for this position is:149,452.92 - 202,112.37Qualifications:Education Required Bachelor's Degree in related discipline or Registered Nurse, equivalent cl...