15 days old

Program Director of HEDIS Performance Measurement - The Colony, TX

Southwestern Health Resources CIN
Dallas, TX 75201
  • Job Code

Southwestern Health Resources (SWHR CIN) seeks to hire a Program Director of HEDIS Performance Measurements to work Full Time supporting the Quality department.

Please note: Southwestern Health Resources Clinically Integrated Network (SWHR CIN) is an affiliated company of Texas Health and UT Southwestern. If hired for this position, you will become a SWHR CIN employee rather than a Texas Health or UT Southwestern employee.

The address is 6800 Windhaven, The Colony, TX 75056

Salary range is Min $42.48 - Max $68.75 - based on relevant experience

Work Schedule

Monday-Friday, 8:00-5:00 p.m.

Job Description

Direct oversight of all SWHR Quality contracts; subject matter expert of contract detail and management.
Contract oversight includes components related to performance metrics and outcomes, alignment of contracted measures, assessment and execution of appropriate contractual delegation between payors and SWHR.
Subject matter expert in regulatory elements, inclusive of Medicare Advantage, MACRA/MIPS.
Collaborates with Quality Director in managing SWHR Quality relationships with all key delegates from ACOs as it relates to meeting the performance metrics facilitates operations meetings with payors, communicates effectively with all external clients.

Collaborates with Quality Director to develop and execute the annual strategic plan that aligns with the SWHR strategic plan and vision.
Collaborates with Quality managers in development, and deployment of key operational initiatives in order to improve/meet contract performance across all SWHR contracts.
Accountable for monitoring contractual performance outcomes and implementing improvement plans as needed to hit contractual performance targets.
Oversees data integrity of payer reports to assist in monitoring contractual performance and identifies opportunities for improvement and develops action plans.
Prepares written and oral presentations for a variety of internal and external audiences, and disseminate progress reports to Executive leadership.
Performs other duties as assigned.

Direct oversight of network-level education/awareness for all Quality and performance improvement.
Develops and operationalizes a comprehensive annual plan for education/awareness.
Accountable for tracking updates and collaborating with leaders on updating educational materials with any updated informational material related to SWHR contracts (e.g. NQCA HEDIS Tech Specs).


The ideal candidate will possess the following qualifications:

Bachelor's Degree Required
Master's Degree Preferred

7 years' experience with Medicare Advantage (MA) or Accountable Care Organization (ACO) Required with Bachelors' Degree OR
5 years' experience with Medicare Advantage (MA) or Accountable Care Organization (ACO) Required with Masters' Degree AND

3 years' Management experience Required

Travel Requirements
10% local travel within D/FW Metroplex as needed for meetings.

Licenses and Certifications
SSBBC - Six Sigma Black Belt Certification Upon Hire Required or
SSGBC - Six Sigma Green Belt Certification Upon Hire Required or
SSLP - Six Sigma Lean Professional Upon Hire Required

Work requires ability to effectively manage payor relationships related to Quality work
Work requires excellent oral and written communication skills
Work requires excellent organizational skills.
Work requires strong analytical/problem solving skills.
Work requires ability to prioritize and organize work to meet deadlines, as well as time management.

Work requires demonstrated ability and skills with project management and quality improvement tools, such as Microsoft Project, Visio, Excel, SharePoint, or Qeystone.

Individual Contributor

ADA Requirements
Working Indoors 67% or more

Physical Demands

Posted: 2019-11-23 Expires: 2019-12-22
Sponsored by:
Farm Credit Services of America Logo
Sponsored by:
Bank of America Logo

Featured Jobs[ View All ]

Featured Employers

Before you go...

Our free job seeker tools include alerts for new jobs, saving your favorites, optimized job matching, and more! Just enter your email below.

Share this job:

Program Director of HEDIS Performance Measurement - The Colony, TX

Southwestern Health Resources CIN
Dallas, TX 75201

Join us to start saving your Favorite Jobs!

Sign In Create Account
Powered ByCareerCast