Director Quality RCM US Healthcare

Designation: Director QualityDepartment: Business Excellence Location: Airoli, Navi Mumbai Experience: 14-18 years Work from office ResponsibilitiesDevelop and implement a comprehensive quality audit strategy aligned with organizational goals and regulatory requirements.Lead the quality audit department, setting direction, establishing performance objectives, and ensuring a highperforming team.Oversee the development and implementation of effective quality audit processes and methodologies.Stay informed on emerging trends and best practices in healthcare quality auditing.Manage a portfolio of quality audits, prioritizing audits based on risk assessments and regulatory requirements.Develop and assign audit plans, scopes, and resources for assigned audits.Lead or oversee the execution of quality audits, ensuring adherence to established procedures and standards.Analyze audit findings, identify root causes of quality issues, and recommend corrective action plans.Track and monitor the implementation of corrective action plans and ensure timely resolution of quality issues.Prepare comprehensive audit reports that detail findings, recommendations, and action plans.Communicate audit results effectively to senior management, stakeholders, and regulatory agencies (if applicable).Develop and deliver presentations on audit findings and trends to raise awareness and drive improvement.Build and maintain strong relationships with internal departments (e.g., clinical, compliance) to facilitate effective audits and collaboration on quality improvement initiatives.Collaborate with external auditors (if applicable) to ensure compliance with regulatory requirements.Foster a culture of quality within the organization by promoting the value and importance of quality audits.Skills RequiredHealthcare Quality Auditing Expertise: In-depth knowledge of healthcare quality auditing principles, methodologies, and best practices (e.g., JCAHO standards, HIPAA regulations).Leadership & Management Skills: Strong leadership skills to motivate, guide, and mentor a team of quality auditors; proven ability to manage multiple projects and resources effectively.Strategic Planning & Analysis Skills: Ability to develop a comprehensive quality audit strategy and translate organizational goals into actionable audit plans.ProblemSolving & Critical Thinking Skills: Strong analytical and problemsolving skills to identify root causes of quality issues and develop effective solutions.QualificationsMasters degree in healthcare administration, Public Health, or a related field is preferred.A minimum of 10-15 years of experience in healthcare quality auditing, with at least 5 years in a leadership role at Senior Manager or equivalent. .