Remote opportunity at
Florida BlueVP Quality and Accreditation
Florida Blue is hiring a remote full-time VP Quality and Accreditation to serve as the enterprise executive accountable for clinical quality performance across commercial and Medicare…
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About This Role
Florida Blue is hiring a remote full-time VP Quality and Accreditation to serve as the enterprise executive accountable for clinical quality performance across commercial and Medicare lines of business. This leadership role oversees HEDIS strategy, clinical quality programs, the HEDIS vendor ecosystem, and accreditation standards including NCQA and URAC. The executive will consolidate previously siloed quality functions into a single operating model to ensure consistent measurement and improvement practices across…
Job Description
Florida Blue is hiring a remote full-time VP Quality and Accreditation to serve as the enterprise executive accountable for clinical quality performance across commercial and Medicare lines of business. This leadership role oversees HEDIS strategy, clinical quality programs, the HEDIS vendor ecosystem, and accreditation standards including NCQA and URAC. The executive will consolidate previously siloed quality functions into a single operating model to ensure consistent measurement and improvement practices across the organization.
The position suits an experienced healthcare executive with a strong background in health plan quality, regulatory compliance, and cross-functional leadership. Florida Blue offers a Be Well, Work Well, GuideWell culture and provides comprehensive employee benefits.
Responsibilities
- Build a unified quality operating model encompassing Medicare and commercial lines of business
- Act as the executive owner for enterprise HEDIS performance and overall accreditation status
- Oversee all HEDIS operations, supplemental data, hybrid strategies, and provider documentation improvement
- Lead enterprise clinical quality programs such as quality improvement initiatives and clinical practice guidelines
- Manage the enterprise accreditation strategy and execution for NCQA, URAC, and state or federal requirements
- Govern the HEDIS vendor ecosystem to reduce costs, strengthen audit defensibility, and establish unified SLAs and KPIs
Requirements
- Possess at least 10 years of leadership experience in health plan Quality, HEDIS, and Accreditation across Medicare and commercial lines
- Demonstrate a track record of improving HEDIS rates and achieving positive NCQA and URAC outcomes
- Demonstrate deep knowledge of HEDIS technical specifications and clinical quality improvement methodologies
- Have experience leading complex vendor ecosystems and large cross-functional teams
- Exhibit strong financial acumen including budgeting, ROI analysis, and forecasting
Qualifications
- Bachelor's degree in business, public health, healthcare administration, or a related field
- Master's degree in business, public health, healthcare administration, or a related field
Core Skills
Benefits
- Medical, dental, vision, life, and global travel health insurance
- Income protection benefits including short-term and long-term disability programs
- Leave programs supporting personal circumstances
- Retirement Savings Plan featuring an employer match
- Paid time off, volunteer time off, 10 holidays, and 2 well-being days
- Additional voluntary benefits and a comprehensive wellness program
- Competitive pay and opportunities for incentive or commission compensation
Frequently Asked Questions
Answers are based only on the employer’s listing; where it doesn’t say, neither do we.
Is this position remote?
Yes, the source posting specifies that the role is remote.
What is the employment type?
This is a full-time position.
What salary is offered for this role?
The salary is not stated in the job posting.
What educational qualifications are preferred?
A bachelor's or master's degree in healthcare administration, public health, business, or a related field is preferred.
Sample Interview Questions
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