Manager, Quality- Remote

Magellan Health

1d • $77,785 - $124,455 • Remote

About The Position

This position will be responsible for HEDIS and NCQA Accreditation. Responsible for assigned areas of quality within a specified unit of a SBU. Implements assigned quality program components. Interfaces with customers and regulatory entities. May have accreditation responsibilities based on contract requirements. Manages day-to-day quality activities ensuring program and procedures support company goals for service, quality, and cost effectiveness as well as compliance with contract, federal and state requirements. Activities and projects may include interfacing with customers on quality programs. Supervises quality staff to ensure successful execution of projects and initiatives. Conducts training sessions on Continuous Quality Improvement (CQI) processes. Coordinates quality initiatives. Coordinates satisfaction survey and follow-up. Coordinates Advisory Groups. Tracks adverse incidents and Quality of Care concerns. Monitors performance measures. Supports provider profiling. Audits for quality control. Conducts quality studies and manages quality improvement projects. Prepares customer and site reports with assistance from Reporting and Analytics team. Participates on quality committees to ensure quality issues are taken to the committee and recommendations are made, by the committee, in a timely manner. Makes recommendations to the Committee for improving plan operations based on data from performance indicators, QI studies, and quality activities. Serves as liaison with assigned departments to ensure quality projects are integrated within operations. Conducts internal audits of charts and clinical/service procedures for quality purposes. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description.

Requirements

• 5+ years of healthcare quality improvement experience.
• Knowledge of quality improvement processes and performance measurement.
• Demonstrated skills in project management.
• Strong interpersonal and organizational skills.
• Expertise in word processing and data management software.
• Bachelor's degree in Healthcare.

Nice To Haves

• Master's degree in Behavioral Health
• LSW - Licensed Social Worker - Care Mgmt

Responsibilities

• Manage day-to-day quality activities ensuring program and procedures support company goals for service, quality, and cost effectiveness as well as compliance with contract, federal and state requirements.
• Supervise quality staff to ensure successful execution of projects and initiatives.
• Conduct training sessions on Continuous Quality Improvement (CQI) processes.
• Coordinate quality initiatives.
• Coordinate satisfaction survey and follow-up.
• Coordinate Advisory Groups.
• Track adverse incidents and Quality of Care concerns.
• Monitor performance measures.
• Support provider profiling.
• Audit for quality control.
• Conduct quality studies and manage quality improvement projects.
• Prepare customer and site reports with assistance from Reporting and Analytics team.
• Participate on quality committees to ensure quality issues are taken to the committee and recommendations are made, by the committee, in a timely manner.
• Make recommendations to the Committee for improving plan operations based on data from performance indicators, QI studies, and quality activities.
• Serve as liaison with assigned departments to ensure quality projects are integrated within operations.
• Conduct internal audits of charts and clinical/service procedures for quality purposes.

Benefits

• Short-term incentives
• Comprehensive benefits package
• Broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager