Director Quality Performance Improvement-SWHR
Director Quality Performance Improvement-Southwestern Health Resources-Clinically Integrated Network (SWHR-CIN)
At Southwestern Health Resources (SWHR), we believe healthcare can be more integrated, accessible, and affordable for all. Our purpose is simple yet powerful: to build a better way to care, together. SWHR is a patient-centered, clinically integrated network that brings together academic and community clinicians, researchers, hospitals, and ambulatory facilities. We partner with physicians to drive a new model of value-based, high-quality, data-driven healthcare—serving everyone in the communities we touch.
By combining the strengths of UT Southwestern Medical Center and Texas Health Resources, we’ve built the largest provider network in North Texas, giving our team members the opportunity to make a meaningful impact at scale. Healthcare in the U.S. is evolving rapidly, and SWHR is committed to leading that change—moving healthcare forward, together.
Position Summary
The Director of Value Based Care Quality and Performance Improvement is responsible for leading enterprise leadership and strategy development for performance improvement in value-based outcomes across Medicare Advantage, MSSP/ACO, Commercial, ACA and Medicaid lines of business. This role is accountable for driving quality, utilization, cost, and patient experience performance through data-driven initiatives, provider engagement, regulatory compliance, and cross-functional collaboration.
· Work location: Hybrid, but the expectation is to be in the office Tuesday – Thursday in Farmers Branch
Position Duties
Strategy & Governance
Own and execute the enterprise quality and performance improvement strategy for all value-based care programs.
Provide executive leadership for Medicare Advantage Stars, CMMI, ACO, and other payor programs
Establish governance structures, priorities, and KPIs to achieve measurable improvement in quality, utilization, cost, and patient experience.
Performance & Contract Management
Drive initiatives to improve contractual performance, realize at-risk revenue, and maximize shared savings.
Implement action plans to meet risk-based and shared savings contract success, including monitoring and improving cost and utilization metrics such as: ED/1000, Admits/1000, MLR, PMPM.
Identify enterprise value-based care program risks and implement mitigation strategies.
Quality & Compliance
Ensure accuracy, integrity, and timely submission of quality data, including HEDIS, Stars, and supplemental data.
Oversee audit readiness, submissions, corrective action plans, and accreditation activities.
Serve as subject matter expert on CMS, CMMI, HEDIS, NCQA, and payer regulations and emerging requirements.
Data Insights
Translate complex performance data into actionable insights through dashboards and executive-level reporting.
Monitor patient experience and utilization data in order to monitor progress, reward/recognize success, identify and prioritize opportunities for improvement and collaborate with vendors.
Collaboration & Provider Engagement
Partner with contracting, finance, and operations to align quality, utilization, patient experience and overall total cost of care (TCOC) incentives with organizational goals.
Collaborate with provider relations, medical economics, clinical leadership, and care management teams to improve provider performance.
Lead workflow optimization initiatives supporting EMR documentation, reporting, and compliance.
Knowledgeable of CAHPS, and other patient experience surveys in the public domain that impact public reporting and value-based reimbursement.
Vendor & Team Leadership
Manage vendor performance related to value-based care analytics, supplemental data, and improvement initiatives.
Lead, coach, and retain high-performing teams; develop departmental budgets and workforce plans.
Executive Reporting
Serve as primary executive contact for payer quality and patient experience discussions.
Prepare and present performance results, trends, and strategic recommendations to senior leadership.
Other duties as assigned
Education
Bachelor's Degree Healthcare Administration, Public Health, Nursing, or related field required
Master's Degree Healthcare Administration, Public Health, Nursing, or related field preferred
Experience
8 years with progressive experience in quality management, value-based care, or managed care environments to include people management experience required with Bachelor’s Degree. Or, 6 years with progressive experience in quality management, value-based care, or managed care environments to include people management experience is required with Master’s Degree
Licenses and Certifications
Lean Six Sigma Certification or Certified Professional Healthcare Quality (CPHQ) preferred upon hire
Skills
People Management - Provides oversight and direction of department leaders in the areas of staffing, talent development, performance management, and resource planning to support strategic goals.
Strategy Execution - Translates organizational strategy into actionable department plans, aligning goals and operations to support long-term success and cross-functional coordination; ensures vision and strategy is clearly communicated to all staff.
Performance & Accountability - Owns department performance by setting clear expectations aligned to strategy, using data to measure and monitor results, identifying risks, generating solutions to improve outcomes and making decisions within departmental scope and escalating when appropriate.
Change Leadership & Operational Readiness - Design change initiatives by implementing new technologies and processes, lead teams through transition, ensuring resources are aligned for success and proactively communicating the purpose and benefit to build engagement.
Strategic Relationship Management - Builds and maintains strategic relationships across departments, with senior leadership, and with external partners, ensuring clear communication, alignment, situational transparency related to business priorities or emerging issues, and accountability for performance expectations.
Financial Resources & Stewardship - Oversees departmental budget and resource planning, ensuring effective use of funds, identifying opportunities for operational efficiency and continuous improvement and making informed decisions to balance competing initiatives and optimize department outcomes.
Why Southwestern Health Resources
As a Southwestern Health Resources you’ll enjoy: comprehensive benefits, including a 401(k) with match; paid time off; competitive health insurance choices; healthcare and dependent care spending account options; wellness programs to keep you and your family healthy; tuition reimbursement; a student loan repayment program; and more.
Explore Southwestern Health Resources Careers for more information and to search all career opportunities.
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