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Travel Nurse RN - Acute Care in Los Angeles, CA

Ambition 24Hours

Los Angeles, CA(remote)

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JOB DETAILS
SKILLS
Accreditation Standards, Acute Care, Analysis Skills, Auditing, Business Administration, Centers for Medicare and Medicaid Services (CMS), Clinical Data, Clinical Outcomes, Coaching, Content Management Systems (CMS), Cross-Functional, Customer Experience, Establish Priorities, Exchange Rates, Health Plan, Healthcare, Healthcare Administration, Healthcare Effectiveness Data and Information Set (HEDIS), Healthcare Quality, Interpersonal Skills, Leadership, Lean Six Sigma, Medicaid, Medicare, Mentoring, National Committee for Quality Assurance (NCQA), Nursing Administration, Operational Audit, People Management, Performance Analysis, Performance Management, Process Improvement, Program Planning, Project/Program Management, Public Health, Quality Assurance, Quality Management, Quality Monitoring, Quality of Care, Registered Nurse (RN), Regulations, Regulatory Reports, Regulatory Requirements, Return on Investment (ROI), Root Cause Analysis, Team Lead/Manager, Trend Analysis, Vendor/Supplier Relations
LOCATION
Los Angeles, CA
POSTED
4 days ago
Director of Quality Health Plan (Remote: OR, WA, CA Only)

This Director of Quality role leads enterprise-wide quality strategy and improvement for a health plan environment, focusing on clinical outcomes, member experience, and top-tier performance in external quality ratings. Candidates must already reside in Oregon (preferred), Washington, or California and will work fully remotely.

About the Role

As Director of Quality, you will design and execute quality strategies to achieve high performance in CMS MA Star Ratings, NCQA ratings and accreditation, Exchange QRS ratings, and Medicaid quality programs. You will oversee quality program design, closing care gaps, and integrating quality initiatives into value-based care and contracting.

Key Responsibilities

  • Lead development and execution of quality strategy and programs to optimize clinical quality and member experience outcomes across all lines of business.

  • Design, implement, and monitor quality improvement programs with clear ROI, feedback loops, and performance tracking against health plan goals.

  • Drive strategy for HEDIS and supplemental data, ensuring strong performance in MA Stars and key HEDIS measures.

  • Use data from clinical quality analytics to identify trends, design interventions, and oversee quality performance reporting.

  • Partner with Health Equity leadership to embed health equity considerations into all quality initiatives.

  • Investigate potential quality-of-care issues, perform systemic and case-specific review, and lead barrier analysis and process improvement efforts.

  • Oversee vendor relationships and contracts related to HEDIS auditing, NCQA reporting, and regulatory/accreditation surveys.

  • Lead, mentor, and develop a team of quality leaders and staff; set priorities, manage performance, and support professional growth.

  • Ensure quality programs and policies align with regulatory requirements and accreditation standards for health plans.

Required Experience & Education

  • Minimum 7 years of management or supervisory experience in a health plan environment.

  • At least 5 years in quality improvement program planning, with a focus on Medicare Advantage (MA) Stars program management.

  • Bachelor s degree in a business or healthcare-related field (e.g., Healthcare Administration, Nursing, Public Health, Business).

  • Experience leading cross-functional, matrixed teams and collaborating with clinical, operational, and analytics stakeholders.

Preferred Qualifications

  • Master s degree in Public Health, Healthcare Administration, Business Administration, or related field.

  • Minimum 3 years of experience with HEDIS audits and reporting.

  • Certified Professional in Healthcare Quality (CPHQ) or similar quality certification.

  • Hands-on experience with quality methodologies and tools such as Six Sigma, Lean, PDSA cycles, Root Cause Analysis, and other performance-improvement frameworks.

  • Proven track record improving health plan quality ratings (MA Stars, NCQA, QRS, Medicaid quality programs).

Core Skills & Competencies

  • Strong project management skills, including ability to manage multiple complex initiatives and competing priorities.

  • Excellent leadership, team management, and coaching capabilities.

  • Advanced analytical and data interpretation skills; ability to translate complex quality data into actionable strategies.

  • Deep knowledge of health plan regulatory and accreditation requirements (CMS, NCQA, Medicaid).

  • Exceptional communication and interpersonal skills, with the ability to influence at all organizational levels.

  • Systems thinking, detail orientation, and a continuous-improvement mindset.

Location & Work Style

  • Fully remote role; must reside in Oregon (preferred), Washington, or California.

  • Occasional travel for key meetings or organizational needs may be required.

Screening Questions (Include in Job Spec)

Please apply if you can answer yes to all three questions below:

  • Do you have a minimum of 7 years of experience working in a health plan?

  • Do you have at least 5 years of leadership experience (management or supervisory)?

  • Do you have at least a Bachelor s degree in a business or healthcare-related field?

  • If you can confidently answer yes to these questions and are passionate about driving healthcare quality and health plan performance, we encourage you to apply

About the Company

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Ambition 24Hours