Sr. Director, Clinical Quality Governance & Regulatory

Location: Atlanta GA (100% Onsite)

Industry: Healthcare / Health Plan & Care Delivery Operations

Position Type: Full-Time New Role

Base Compensation: $194700 $251900 / year (Midpoint $229000; compensation flexibility available for exceptional candidates)

Incentive: 20% Annual Target Bonus

Relocation: Case-by-case eligibility

Sponsorship:No visa sponsorship provided

The Senior Director Clinical Quality Governance & Regulatory provides high-level strategic oversight for clinical quality patient safety risk management credentialing peer review and regulatory compliance across both health plan and care delivery operations.

Serving as a trusted expert and key partner to local and national executive boards this leader establishes overarching governance frameworks drives evidence-based practice changes and ensures organizational accountability. This role translates regulatory and accreditation requirements into actionable long-term continuous improvement strategies that minimize liability elevate clinical outcomes and uphold operational excellence.

• Executive Advisory: Serve as a subject matter expert to executive leadership and boards providing strategic guidance on clinical quality patient safety and liability mitigation.
• Team Development: Build organizational capacity mentor high-potential staff oversee talent selection and drive continuous learning and cross-functional engagement.
• Operational Alignment: Translate macro-level business strategies into unit goals managing budgets resource allocation and operational risk across multiple departments.

• Data & Analytics Oversight: Direct data collection statistical analyses and reporting workflows (e.g. Lean/Six Sigma) to evaluate quality metrics identify clinical trends and present findings to executive leadership.
• Risk & Patient Safety: Oversee root cause analyses (RCA) failure mode and effects analyses (FMEA) near-miss responses and medical center liability monitoring to establish corrective policies and reduce risk.
• Metric Integration: Consult with cross-functional executive stakeholders to establish practical reachable and standardized performance metrics integrated directly into clinical workflows.

• Continuous Survey Readiness: Lead ongoing readiness initiatives for state federal and continuous survey accreditation bodies (e.g. The Joint Commission NCQA CMS).
• Agency Relations: Cultivate strong collaborative partnerships with government and regulatory agencies staying ahead of legislative changes impacting health plan and delivery operations.
• Credentialing & Peer Review: Oversee processes and criteria for clinical performance reviews credentialing and peer reviews at the organizational level.

• Leadership Experience: Direct executive/quality leadership experience within a large healthcare system or hospital setting AND health plan experience.
• Clinical Background: Hands-on clinical experience alongside administrative leadership.
• Core Subject Expertise: Deep expertise in Credentialing Peer Review Patient Safety Risk Management and Quality Governance.
• Regulatory & Quality Programs: Proven track record with:
  • CMS 5-Star ratings
  • HEDIS metrics
  • The Joint Commission survey leadership
  • NCQA outcomes

• Experience:

• Minimum 8 years of experience in a clinical setting healthcare administration or related field.
• Minimum 6 years in a leadership role managing direct reports.
• Minimum 4 years managing operational or project budgets.
• Minimum 2 years working with databases spreadsheets or Continuous Quality Improvement (CQI) tools.
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• Education & Experience Combinations:
  • Masters Degree (MBA HCA MSN MPH or related) 8 years of healthcare quality assurance/improvement experience OR
  • Bachelors Degree (BA/BS in related field) 10 years of healthcare quality assurance/improvement experience OR
  • 13 years of progressive experience in healthcare quality assurance/improvement.

• Active RN License: Current Registered Professional Nurse License in the State of Georgia (or clear path to obtain prior to hire).
• Certifications: Must possess (or obtain within 24 months of hire) at least one of the following:
  • Certified Professional in Patient Safety (CPPS)
  • Certified Professional in Healthcare Quality (CPHQ)
  • Certified Professional in Healthcare Risk Management (CPHRM)