Director, Care Management & Quality at WVU Medicine

Role Overview

The Director of Care Management & Quality at WVU Medicine's Peak Health is a critical leadership role responsible for overseeing and directing the health plan's care management and quality improvement programs. This role involves developing and implementing strategies to improve patient outcomes, enhance member experience, and optimize cost efficiency across various populations, including commercial and Medicare members. The Director leads initiatives related to HEDIS and Medicare Star Ratings, ensuring compliance with regulatory standards and driving performance improvements. This position reports to the Health Plan President and is an integral part of the senior leadership team.

A Day in the Life

On a typical day, the Director of Care Management & Quality might: * **Lead strategic planning sessions:** Collaborating with senior leaders to develop and refine care management and quality improvement strategies. * **Analyze performance data:** Reviewing HEDIS and Star Ratings data to identify trends, areas for improvement, and opportunities for targeted interventions. * **Oversee program implementation:** Ensuring that care management and quality improvement programs are effectively implemented and monitored. * **Manage a team:** Providing guidance, support, and mentorship to care management and quality staff. * **Collaborate with stakeholders:** Working with providers, administrators, and other stakeholders to align efforts and achieve common goals. * **Address compliance issues:** Staying abreast of regulatory changes and ensuring compliance with all applicable standards. * **Develop and present reports:** Preparing and presenting reports on program performance and outcomes to senior leadership.

Why Morgantown, West Virginia?

Morgantown, West Virginia, offers a unique blend of small-town charm and big-city amenities. As the home of West Virginia University, Morgantown is a vibrant and diverse community with a thriving arts and culture scene. The city boasts a low cost of living, excellent schools, and a wide range of outdoor recreational opportunities. WVU Medicine is a major employer in the area, providing stable and rewarding career opportunities. Morgantown's central location also makes it a convenient base for exploring other parts of West Virginia and the surrounding region.

Career Path

The Director of Care Management & Quality role offers significant opportunities for career growth within WVU Medicine. Potential career paths include: * **Senior Director, Care Management & Quality:** Overseeing a larger portfolio of programs and initiatives. * **Vice President, Population Health:** Leading population health strategies across the organization. * **Chief Quality Officer:** Assuming overall responsibility for quality improvement efforts. * **Executive Leadership:** Progressing into executive leadership roles within WVU Medicine.

Salary & Benefits

The estimated salary range for the Director of Care Management & Quality position at WVU Medicine is $110,000 to $160,000 per year, depending on experience and qualifications. In addition to a competitive salary, WVU Medicine offers a comprehensive benefits package, including: * Comprehensive health insurance (medical, dental, vision) * Paid time off (PTO) and holidays * Retirement plan with employer matching * Life insurance and disability coverage * Employee assistance program (EAP) * Wellness programs * Professional development opportunities * Tuition assistance * Flexible spending accounts (FSA) * Commuter benefits * Employee discounts

WVU Medicine Culture

WVU Medicine is committed to providing exceptional patient care and fostering a supportive and collaborative work environment. The organization values teamwork, innovation, and continuous improvement. Employees are encouraged to develop their skills and advance their careers. WVU Medicine is also dedicated to serving the community and promoting health and wellness.

How to Apply

To apply for the Director of Care Management & Quality position at WVU Medicine, please visit our careers page at [WVU Medicine Careers Website]. Submit your resume and cover letter, highlighting your relevant experience and qualifications. Be sure to complete the application in full.

FAQ

**1. What are the key responsibilities of the Director of Care Management & Quality?** The Director is responsible for leading the development and implementation of clinical intervention strategies, overseeing healthcare quality improvement initiatives, and ensuring compliance with regulatory standards. **2. What qualifications are required for this role?** Minimum qualifications include a Bachelor's Degree in Healthcare Administration, Public Health, or a related field, along with five years of prior management experience in Care Management and/or Quality in a managed care setting. **3. What is the salary range for this position?** The estimated salary range is $110,000 to $160,000 per year, depending on experience and qualifications. **4. What benefits does WVU Medicine offer?** WVU Medicine offers a comprehensive benefits package, including health insurance, paid time off, retirement plan, and professional development opportunities. **5. Where is the position located?** The position is located at the Peak Health Administrative Building in Morgantown, West Virginia. **6. What is the work environment like at WVU Medicine?** WVU Medicine fosters a supportive and collaborative work environment with a focus on teamwork and continuous improvement. **7. What are the opportunities for career advancement?** Potential career paths include Senior Director, Vice President, and Chief Quality Officer, among others. **8. How do I apply for this position?** Please visit our careers page at [WVU Medicine Careers Website] and submit your resume and cover letter. **9. What is HEDIS?** HEDIS (Healthcare Effectiveness Data and Information Set) is a set of standardized performance measures used to assess the quality of healthcare plans. **10. What are Medicare Star Ratings?** Medicare Star Ratings are a system used by the Centers for Medicare & Medicaid Services (CMS) to rate the performance of Medicare Advantage and Part D plans.