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Johns Hopkins Health Plans
Hanover, MD, United States
Summary The Executive Director of Corporate Compliance and Regulatory Affairs (“Exec. Director”) at Johns Hopkins Health Plans (JHHP) reports to the Johns Hopkins Health System (JHHS) Chief Compliance Officer (and reports via a matrix relationship to the President of JHHP). The Exec. Director is responsible for the development, implementation, comm
Job Source: Johns Hopkins Health PlansJohns Hopkins Medicine
Hanover, MD, United States
Share This Page Job Details Requisition #: 631778 Location: Johns Hopkins Health Plans, Hanover, MD 21076 Category: Non-Clinical Professional Schedule: Day Shift Who you are: As a Business Analyst in Quality Improvement for Johns Hopkins Health Plans, you will work with a team to improve HEDIS measure performance across three lines of bus
Job Source: Johns Hopkins MedicineJohns Hopkins Medicine
Hanover, MD, United States
Share This Page Job Details Requisition #: 630166 Location: Johns Hopkins Health Plans, Hanover, MD 21076 Category: Leadership Schedule: Day Shift Summary The Executive Director of Corporate Compliance and Regulatory Affairs ("Exec. Director") at Johns Hopkins Health Plans (JHHP) reports to the Johns Hopkins Health System (JHHS) Chief Com
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Job DescriptionJob Description Job description 1st Choice is searching for a dynamic and passionate Health Program Manager, w/an LMSW, to manage an assessment program serving Medicaid members in the Baltimore City Market. Supports and implements the Client and Company's mission, vision, and core values within the Assessment Program. Responsibi
Job Source: 1st Choice, LLCJohns Hopkins Medicine
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Share This Page Job Details Requisition #: 637134 Location: Johns Hopkins Health Plans, Hanover, MD 21076 Category: Leadership Schedule: Day Shift Job Summary Reporting to the VP & COO, the Exec Dir Sales & Marketing leads the organization's marketing, communications, sales, and market development functions. The leader is responsible for
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Job Source: LivantaJohns Hopkins Medicine
Hanover, MD, United States
Share This Page Job Details Requisition #: 635469 Location: Johns Hopkins Health Plans, Hanover, MD 21076 Category: Leadership Schedule: Day Shift Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3.2B business serving nearly 500,000 members with lines of business in Me
Job Source: Johns Hopkins MedicineMindoula Health Inc
Baltimore, MD, United States
Mindoula is a next generation population health management company that identifies, engages, and serves populations with complex behavioral health, medical, and social challenges across the continuum of care. By using technology to “scale the human connection,” Mindoula helps health plans, health systems, hospitals, and provider groups extend their
Job Source: Mindoula Health IncHanover, MD, United States
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Job Details
Requisition #: 638276
Location: Johns Hopkins Health Plans,
Hanover,
MD 21076
Category: Leadership
Schedule: Day Shift
Job Summary
Under the direction of the Associate Chief Medical Officer, Quality & Transformation, this execution-focused position of the Quality Performance Director, for Medicaid, USFHP & EHP will support quality performance management for the Medicaid line of business, Priority Partners Managed Care organization (PPMCO), TRICARE Prime (USFHP), and Commercial (Employer Health Program) lines of business for JHHP.
Responsible for developing and driving the enterprise-wide Medicaid VBP, USFHP, and EHP performance improvement and implementation through evaluating strategies, external capabilities and vendors to help drive best-in-industry performance. Responsible for identifying innovative strategies to set market leading performance for PPMCO VBP, USFHP, and EHP measures and initiatives. Must have deep industry connections to cutting edge strategies and external partners that can accelerate and maintain as an industry leader. Works collaboratively with PPMCO, USFHP, and EHP, enterprise leaders, and internal leadership to establish baseline capabilities and develop strategies for capability enhancement. Extensive market knowledge and research capability is necessary to best be able to evaluate opportunities. Collaborates and coordinates work with peers, other departments within matrix/shared service partners (including but not limited to Provider Relations, Pharmacy, Care Management, Utilization Management, Compliance, Appeals, Marketing and Communications, and IT).
This position will be responsible for the planning, development and execution of activities that support the Maryland Department of Health (MDH) or External Quality Review Organization (EQRO), Qlarant required deliverables such as audits, corrective actions, performance improvement plans (PIPs) as well as VBP strategies. In addition, this position will serve as quality lead for USFHP and EHP deliverables related to quality improvement.
Qualifications
Bachelor's degree in health administration or a related field required. Advanced coursework and/or Master's degree preferred. Minimum 3-5 years of managed care experience, specifically in government programs, is required. + 3 - 5 years in Strategic Planning, + 1 - 3 years in Operational Excellence, + 1 - 3 Vendor Management, + 1 - 3 years in Medicare, Medicaid and Commercial;
TRICARE/TRICARE PRIME experience a plus
Minimum of 8- 10 years of healthcare experience with thorough knowledge of healthcare quality improvement, industry standard performance measures, healthcare reimbursement including valued based purchasing methodology and management, managed care, and tactics that result in member and provider engagement. Prefer 3-5 year supervisory experience and experience with government contracts related to healthcare deliverables
Many organizations talk about transforming the future of healthcare, at Johns Hopkins Health Plans, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home.
Please note: US citizenship is required for this position as it falls under the terms of a government contract (to ensure compliance with DODPSP).
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Director of Medicaid and Commercial Quality Performance jobs in Hanover, MD, United States
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