Director Quality Management

Amerihealth Caritas•Lower Paxton Township, PA

2d•Hybrid

About The Position

The Director of Quality Management is responsible for the Outcomes Management and Quality Improvement Plan, a program of systematic and objective activities designed to continuously monitor, evaluate, and improve the processes of delivering behavioral health and substance use services, services for intellectual/developmental disabilities, and the quality of clinical care and services provided to children, youth, young adults, and their family/caregivers. The Director is responsible for a formal outcomes assessment process that is standardized, reliable, and valid in accordance with industry standards.

Requirements

Master’s degree in social work, nursing, counseling, or doctorate in psychology required.
Must be a PA licensed RN, physician, physician’s assistant or a licensed or certified MH Professional or is a Certified Professional in Healthcare Quality (CPHQ) or is Certified in Healthcare Quality and Management (HCQM)
10 years’ experience in healthcare and in quality assurance and improvement.
Knowledge and experience of statistics and research to conduct data analysis/evaluation.
Excellent communication skills: Verbally and in writing with all internal and external customers.
Strong presentation skills required.
Ability to handle conflict and difficult situations.
Strong time management, project management, and organizations skills.
Ability to use PC’s in a Windows based environment.
Ability to foster growth and teamwork.
Strong & demonstrated leadership and management skills resulting in the ability to make decisions independently and manage personnel.
Must reside in Pennsylvania.
Must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required.

Responsibilities

Oversight of complaints and grievances, credentialing, quality of care, policies and procedures, NCQA, internal and external audits and treatment record reviews.
Provides quality leadership in the development of new and improved clinical and administrative processes to maximize effective operations and ensures that contract deliverables are met.
Provides organization-wide monitoring of outcomes, data analysis, and improvement of quality, clinical and non-clinical processes. Utilizes this data to support and collaborate with all departments.
Requires extensive experience developing, interpreting, and presenting reports and analyses to support decision-making and collaboration across departments.
Supervises a team of quality coordinators, manages assignments and provides feedback on job performances and goals.