VP Quality and Accreditation

The Vice President, Quality & Accreditation is the enterprise executive accountable for clinical quality performance across all lines of business, including Medicare and Commercial. This role owns HEDIS strategy and operations, accreditation (NCQA, URAC, and applicable state/federal standards), clinical quality programs, and the vendor ecosystem that supports HEDIS data collection, abstraction, and reporting. This executive unifies quality functions historically siloed by line of business into a single operating model, ensuring consistent measurement, documentation, and improvement practices across Medicare and Commercial populations. The role is accountable for HEDIS rates and audit results, accreditation status and survey outcomes, clinical quality program performance, and vendor ecosystem governance and cost. Key Responsibilities: Enterprise Quality Leadership & Operating Model • Build a unified quality operating model across all lines of business, including Medicare and Commercial. • Establish enterprise governance for clinical documentation integrity supporting quality measurement. • Serve as the executive owner of enterprise HEDIS performance and accreditation status. • Oversee all HEDIS operations, hybrid strategy, supplemental data, and provider documentation improvement, across Medicare and Commercial lines of business. • Develop best-in-class intervention playbooks for each HEDIS measure. Clinical Quality Lead enterprise clinical quality programs, including