Director, Quality Operations

Job Description:

The Director, Quality Operations is a strategic and operational leader responsible for the accuracy, completeness, and integrity of the data that drives Cityblock's performance on contracted quality measures. This leader ensures we have the most complete picture of member gaps in care and that our data is validated before it is sent to partners, so our performance is accurately and fully reflected. The role also owns data governance for membership-related information and processes for Cityblock contracts.

Responsibilities

• Serve as Cityblock's HEDIS subject matter expert, with deep knowledge of HEDIS measure specifications, data sources, and reporting requirements.
• Lead Cityblock's HEDIS audit readiness and participation, including audit preparation, documentation, and response.
• Drive data completeness and accuracy across systems, identifying and closing data gaps so that performance is accurately reflected before data is submitted to partners.
• Own the management and ongoing optimization of Cityblock's third-party HEDIS engine, which ingests data and reports on our performance. This includes data inputs, validation of outputs, and engine configuration and workflows.
• Maintain a complete, accurate view of member gaps in care, partnering with market, clinical, and operations teams so that gap closure is supported by reliable data.
• Lead and develop a small team of Managers and Senior Associates
• Evaluate system and workflow processes to find and fix root causes of data quality issues, and provide training to the teams involved.
• Collaborate across clinical and non-clinical teams (operations, technology, compliance, finance) and with market teams to implement enterprise-wide initiatives that support contracted quality measure performance.
  

Requirements

• Master's-level education or work in a healthcare field (MHA, MBA, or MPH) required; clinical experience a plus.
• 7+ years of experience in a healthcare setting (provider, hospital, value-based care, consulting, or health plan) working with quality reporting and operations, alongside care teams.
• Demonstrated HEDIS expertise, including understanding of HEDIS data and hands-on experience going through HEDIS audits.
• Proficiency in Excel and Google Sheets for data manipulation. Experience with coding languages is a plus.
• Experience improving data completeness and accuracy to support quality performance reporting.
• Experience working with HEDIS engines

We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company’s equity program, paid time off, including vacation and sick leave. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location. The expected salary range for this position is:

$125,000.00 - $165,000.00 Annual

Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.

About Us:

Cityblock Health is the first tech-driven provider for communities with complex needs—bringing better care to where it’s needed most, block by block. Founded in 2017 on the premise that “health is local” and based in Brooklyn, we are backed by Alphabet’s Sidewalk Labs along with some of the top healthcare investors in the country.

Our mission is to improve the health of underserved communities. Importantly, our solutions are designed specifically for Medicaid and lower-income Medicare beneficiaries, and we meet our members where they are, bringing care into the home and neighborhoods through our community-based care teams and Virtual Care offerings.

In close collaboration with community-based organizations, local providers, and leading health plans, we are reorganizing the health system to focus on what matters to our members. Equipped with world-class, custom care delivery technology, we deliver personalized primary care, behavioral health, and social services to deliver a radically better experience of care for every member and community we serve.

Over the next year, we’ll grow quickly to bring better care to many more members and their communities. To do this, we need people who, like us, believe that everyone should have good care for what matters to them, in their community.

Our work is grounded in a belief in the power of a diverse community. To close gaps in care and advance equity in the communities we serve, we have to start with making our own team diverse and inclusive. Our ways of working are characterized by creativity, collaboration, and mutual learning that comes from bringing together a community from diverse backgrounds and perspectives. We strive to ensure that every person on the Cityblock team, and every Cityblock member, feels supported and included as a part of our community.

Our Values:
Aim for Understanding
Be All In
Bring Your Whole Self
Lean Into Discomfort
Put Members First

About our Team:
We employ a field-based, home-based care model and are committed to meeting members where they are--in their homes, in their community, and in our Hubs. We will go above and beyond to connect with Cityblock members in a non-judgmental, respectful and empathic manner, to meet their needs, and to provide feedback to the system as a whole as we strive to do better every day.