Claims Quality Audit Director jobs in Rochester, NY

• Leading/overseeing all aspects of internal and external quality, performance competency and compliance relating to all VOH operations as well as the establishment of new quality standards, and performance systems supporting strategic initiatives.
• Driving strategic quality and performance goals and leading quality improvement initiatives, ensuring compliance with regulatory standards, and fostering a culture of continuous improvement within VOH programs.
• Oversees areas of compliance, incident management, policy development, education, training, skill building, competency management and performance assessment in collaboration with program leadership.

DUTIES/RESPONSIBILITIES:

• This position provides leadership and direction to quality and training personnel
• Partners with Executive Leadership Team (ELT) as part of the Operational Leadership Team (OLT) to establish strategic goals for quality and performance, and establishes and monitors key performance indicators (KPIs) related to quality initiatives.
• Coordinates data abstraction, extraction, analysis, and intervention for quality assessments and validation.
• Use data-driven insights and qualitative intelligence to recommend improvements and action plans.
• Prepare and present regular reports on clinical quality metrics to Executive Leadership and VOH Board of Directors.
• Tracks performance improvement initiatives to ensure that objectives are met and recommended actions are fully implemented
• Serves as champion and steward of VOH Sanctuary model and practice.
• Partners with program leadership to identify, plan and coordinate clinical and non-clinical education, training, certifications, and refresher training to obtain cultural competencies and best practices as needed.
• As a change agent, shapes and cultivates an institutional culture that values continuous learning and development through a lens of a positive employee experience for all
• Assists program leaders in the development of trauma-informed and compliant policies and clinical standards of care.

• Strong analytical and data interpretation skills
• Excellent leadership, communication, and team-building skills
• Strong presentation skills with demonstrated ability to present to executive leadership audiences
• Excellent communication, interpersonal, and project management skills
• High level of analytical ability necessary to identify and illustrate relationships among activities, recommend courses of action based on making choices among alternative and design recommended
• Demonstrated knowledge of and effective application of project management, collaboration, and efficiency tools, documentation, and processes.
• High level of proficiency with Microsoft Excel and PowerPoint
• Working knowledge of adult learning principles, e-learning and leadership and employee development strategies, tools, and practices
• Demonstrated appreciation for different backgrounds and life experiences