Director, Quality Operations

Cityblock Health

2d•$125,000 - $165,000

About The Position

The Director, Quality Operations is a strategic and operational leader responsible for the accuracy, completeness, and integrity of the data that drives Cityblock's performance on contracted quality measures. This leader ensures we have the most complete picture of member gaps in care and that our data is validated before it is sent to partners, so our performance is accurately and fully reflected. The role also owns data governance for membership-related information and processes for Cityblock contracts.

Requirements

Master's-level education or work in a healthcare field (MHA, MBA, or MPH) required; clinical experience a plus.
7+ years of experience in a healthcare setting (provider, hospital, value-based care, consulting, or health plan) working with quality reporting and operations, alongside care teams.
Demonstrated HEDIS expertise, including understanding of HEDIS data and hands-on experience going through HEDIS audits.
Proficiency in Excel and Google Sheets for data manipulation.
Experience improving data completeness and accuracy to support quality performance reporting.
Experience working with HEDIS engines

Nice To Haves

Experience with coding languages is a plus.

Responsibilities

Serve as Cityblock's HEDIS subject matter expert, with deep knowledge of HEDIS measure specifications, data sources, and reporting requirements.
Lead Cityblock's HEDIS audit readiness and participation, including audit preparation, documentation, and response.
Drive data completeness and accuracy across systems, identifying and closing data gaps so that performance is accurately reflected before data is submitted to partners.
Own the management and ongoing optimization of Cityblock's third-party HEDIS engine, which ingests data and reports on our performance. This includes data inputs, validation of outputs, and engine configuration and workflows.
Maintain a complete, accurate view of member gaps in care, partnering with market, clinical, and operations teams so that gap closure is supported by reliable data.
Lead and develop a small team of Managers and Senior Associates
Evaluate system and workflow processes to find and fix root causes of data quality issues, and provide training to the teams involved.
Collaborate across clinical and non-clinical teams (operations, technology, compliance, finance) and with market teams to implement enterprise-wide initiatives that support contracted quality measure performance.