Hiring: Quality Business Operations Director (Hybrid) Company: CareFirst BlueCross BlueShield Location: Baltimore, MD Job Posted Time: 2026-09-12 11:49:29 Employment Type: Hybrid Target Skills & Keywords : Microsoft Office, Population Health Management, Regulatory Compliance, Vendor Management About the job Experience: •8 years experience in a healthcare, public health, health insurance, quality/process improvement or data management business environment •3 years management experience Required Skills: •Lead enterprise HEDIS strategy, annual submission activities, and roadmap execution, including management of work plans, timelines, data acquisition strategies, vendor and provider data exchanges, audit readiness, accreditation support, and continuous quality improvement initiatives across all lines of business. •Drive quality performance analytics and operational improvement efforts through trend analysis, year-over-year performance reviews, HEDIS and Stars score optimization, post-audit improvement planning, and the development of actionable reporting, scorecards, and measurement frameworks •Maintains knowledge of current and future NCQA, NQF, CMS/Federal, State, regulatory and healthcare quality measurement requirements and accreditation standards. Actively participates in or chairs committees, sub-committees, enterprise & Industry workgroups as assigned to report, champion an advocate quality improvement, across populations. •This position manages people. Qualifications: •Bachelor's Degree in business administration, health policy, health services research, public health, economics, mathematics, computer science, or a related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience. •Training or certification in Quality or Process Improvement Methods •Certified Professional in Healthcare Quality certification •5+ years of Quality Engine management, product or platform ownership •Roadmap development and audit support •Data acquisition of health care data through standard and non-standard data sources •Vendor management •Knowledge, Skills And Abilities (KSAs) •Demonstrated capacity to perform qualitative and quantitative data analyses and create innovative strategies and work with colleagues to address findings. •Demonstrated capacity to learn the technical aspects of collection and reporting of both administrative and clinical aspects of quality measures. Compensation: •$142,560 - $264,627 / year •Competitive benefits and rewards package Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!