Director, Clinical Quality, Training, Oversight and Innovation

18 hours, 31 minutes ago
Full-time
Lead
Quality Assurance and Testing
Inovalon

Inovalon

Inovalon provides cloud-based platforms that facilitate a data-driven transformation in the healthcare industry, enabling organizations to enhance clinical outcomes and financial performance through advanced analytics and large-scale data interconnecti...

IT Services
1K-5K
Founded 1998

Description

  • Define and execute the organization’s clinical quality strategy for medical record data abstraction across all Inovalon products.
  • Lead the design and execution of clinical training and quality oversight for internal teams and international vendors.
  • Serve as subject matter expert for risk adjustment and HEDIS and support client services, business development, and marketing efforts.
  • Develop, update, and deliver training materials for accurate medical data abstraction in compliance with coding and regulatory requirements.
  • Oversee quality assurance processes for internal staff, partners, and vendors, including quality pullback processes and tool upgrades.
  • Lead Joint Quality Audit processes for RA and HEDIS clients and represent Inovalon in third-party audits and client-specific projects.
  • Collaborate with Product, Operations, Client Services, MRR Operations, and Innovation teams on clinical direction and process improvement.
  • Serve as clinical expert in the development and improvement of medical data abstraction tools and systems.
  • Partner with Innovation on new capabilities such as NLP and due diligence for onboarding new EMR partners.
  • Design and execute clinical quality oversight processes for records received through EMR interoperability capabilities.

Requirements

  • Bachelor’s degree in Arts/Sciences (B.A./B.S.) preferred.
  • Active RN license required.
  • 12+ years of relevant overall experience required.
  • 6 years of high-level management experience, preferably at Director level or higher, required.
  • 5 years of experience in quality and/or compliance required.
  • 5 years of experience in medical coding required.
  • 5 years of experience with adult learning/training required.
  • Strong computer skills, especially with Microsoft Office and data collection tools.
  • Outstanding attention to detail with the ability to manage multiple priorities and deadlines.
  • Applicants must be authorized to work in the United States; no immigration sponsorship available for this role.

Benefits

  • Base compensation range of $132,000 to $176,000 USD.
  • Eligible for performance-based incentives.
  • Health insurance and life insurance may be included.
  • Company-paid disability coverage.
  • 401(k) retirement plan.
  • 18+ days of paid time off.
  • Benefits package designed to support health and long-term financial goals.
  • Flexible consideration of candidate experience, location, and internal equity in compensation decisions.

Interested in this position?

Apply directly on the company website

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