Director of Quality Health


  • Required: Minimum of Bachelor's Degree in HealthCare, Nursing, Public Health, Health Administration, Behavioral Health or directly related field
  • Master's Degree in the above fields is preferred
  • 4+ years of experience in quality health programs, plus 5+ years of experience in managed care setting is a plus
  • Experience in Behavioral Health environment is preferred
  • Familiarity with Joint Commission, URAC, AAAHC and NCQA standards
  • Strong written, interpersonal and verbal communication skills
  • Strong analytical and problem- solving skills and knowledge of healthcare delivery
  • Able to lead/manage others and influence internal and external stakeholders
  • Able to implement process improvements
  • Able to set a clear mission, vision and objectives for the department fostering teamwork
  • Establish an environment of accountability and continuous quality improvement
  • Improves team and individual performance through coaching, inspiration and management
  • Delegate tasks and provides team leaders with the education, skills and resources to succeed.

Role and Responsibility for Quality: Improve Quality of Care  

The Director of Quality Health (DQH) is responsible for improving the health, well-being and quality care of our members. They focus on clinical, medical, health, and regulatory improvements. They support education and recommend tools, policies, procedures, and reporting to support improving quality care.

The DQH manages the medical department and has specific responsibility for the following:

  • Supporting the Triple Aim: Improved quality of care, increased patient satisfaction and reduced cost of care (populations)
  • Ensuring CHP meets Quality regulations on a state by state basis
  • Expanding the use of technology to enhance services including affiliated partners
  • Managing the internal team to deliver quality case management and coordinated care
  • Supporting Medical Review and Management with the CMO to validate quality care:
    • Ensuring CHP meets its goals, objective and targets with respect to Quality Outcomes and Reporting Measures
    • Improvements in quality of care and quality of care scores
    • Supports Credentialing Oversight through the team and vendors
    • Supports Grievance and Appeals Oversight through Appeals Department
  • The DQH implements the annual quality health work plan and supports the mission and strategic goals of the organization, federal and state laws and regulations, and accreditation standards; The DQH facilitates and participates on committees: Medical Management and Quality Health Committees.

    Reporting to: Chief Medical Officer


    Please send your resume and completed application to CHP Human Resources at:

    Mail: Consolidated Health Plans, Human Resources, 2077 Roosevelt Avenue, Springfield, MA 01104-3503

    Fax: (413) 452-5329 Attn. Human Resources


    Phone: (413) 733-4540 ext. 120


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    For more information contact us at or call us at (413) 733-4540 ext. 120