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Vice President, Quality & Controls Assurance

Philadelphia, PA, United States

Vice President, Quality & Controls Assurance

About the Company

Large community-based healthcare organization

Industry

Hospital & Health Care

Type

Non Profit

Founded

2003

Employees

1001-5000

Categories

Health Care

Hospital

Non-Profit & Philanthropy

Community Health

Senior Care

Healthcare

Medical Care

Behavioral Science

Support

Affordable Healthcare Services

Ambulatory Services

Health & Drug Screening

Ambulance

Specialties

Integrated healthcare

Dual Eligibles

Enhanced primary care

Coordination of care

Healthcare for Seniors

Keeping seniors independent

Provide care manager

Assistance for family caregivers

Home visits

and More benefits than MassHealth

Business Classifications

B2C

About the Role

The Company is seeking a Vice President for a remote Quality and Controls Assurance role. The successful candidate will be responsible for leading a wide range of quality reviews, including claims, clinical coding, and operational controls. This leadership position involves strategic and operational oversight of quality audits, error pattern evaluation, and ensuring the reporting of relevant results to the appropriate departments. The role also includes managing internal and external audit processes, as well as leading teams in SOX, SOC, and MAR testing and assurance. The VP will be expected to collaborate with business owners to address error root causes and facilitate quality improvement, as well as to oversee special projects and regulatory reviews.Candidates for this position should have a Bachelor's degree in a relevant field, with a preference for a graduate degree and professional certifications. A minimum of 10 years' of audit, quality assurance, or related experience is required, with at least 6 years' in the healthcare industry. The role demands a leader with strong knowledge of government healthcare programs and regulatory requirements, as well as experience in managing a substantial portfolio of audits and quality assurance reviews. The ideal candidate will have excellent communication and influencing skills, the ability to build strong relationships, and a strategic, innovative approach to quality and controls assurance. Strong emotional intelligence and a commitment to upholding organizational values are also essential.

Hiring Manager Title

Chief Risk Officer

Travel Percent

Less than 10%

Functions

Finance

General Management

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