Sr. Quality Specialist, MFLC (Remote)

Magellan Health
$70,715 - $113,145Remote

About The Position

Serves as a member of the quality team for the Military & Family Counseling Program. Conducts audits of operational procedures, processes, and reported outcomes. Recommends and participates in continuous quality and process improvement activities. Supports the maintenance of a strong quality program. Serves as quality improvement specialist for the quality program with the goal to meet contractual requirements and performance guarantees. Duties include evaluating current processes; conducting gap analyses, and recommending/participating in quality improvement activities to address gaps and increase compliance with contractual requirements. Leads and performs all aspect of audit processes, including planning, testing, data collection and analysis. Prepares objective, factual reports of audit outcomes including best practices, opportunities for improvement, training needs, future risks. Develops/revises operational policies and procedures and instructional materials after mitigation/correction activities are determined. Coordinates with any vendors outreach and interventions. Prepares status reports on activities and outcomes of interventions and activities. Supports monthly, quarterly and annual reporting and trending of performance measures identified on the Quality Control Plan. Supports survey administration and collection of responses. Provides documentation for quality reports required by the contract. 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

  • 3-5 years of experience in quality improvement.
  • Knowledge quality improvement processes.
  • Attention to detail and able to work efficiently to meet deadlines and timelines.
  • High degree of organization required.
  • Excellent verbal and written skills and the ability to enter data accurately into spread sheets and prepare professional looking documents and reports.
  • Proficient in data management, data analysis, reporting word processing, and project management.
  • Basic statistical skills.
  • Bachelor's - Healthcare
  • Registered Nurse (RN) - Care Mgmt
  • State and/or Compact State Licensure - Care Mgmt

Nice To Haves

  • Salesforce and Microsoft office platforms.
  • Master's - Healthcare
  • CPHQ - Certified Professional In Healthcare Quality - Care Mgmt
  • LSSBB - Lean Six Sigma Black Belt Certification - Enterprise

Responsibilities

  • Conducts audits of operational procedures, processes, and reported outcomes.
  • Recommends and participates in continuous quality and process improvement activities.
  • Supports the maintenance of a strong quality program.
  • Serves as quality improvement specialist for the quality program with the goal to meet contractual requirements and performance guarantees.
  • Evaluates current processes.
  • Conducts gap analyses.
  • Recommends/participates in quality improvement activities to address gaps and increase compliance with contractual requirements.
  • Leads and performs all aspect of audit processes, including planning, testing, data collection and analysis.
  • Prepares objective, factual reports of audit outcomes including best practices, opportunities for improvement, training needs, future risks.
  • Develops/revises operational policies and procedures and instructional materials after mitigation/correction activities are determined.
  • Coordinates with any vendors outreach and interventions.
  • Prepares status reports on activities and outcomes of interventions and activities.
  • Supports monthly, quarterly and annual reporting and trending of performance measures identified on the Quality Control Plan.
  • Supports survey administration and collection of responses.
  • Provides documentation for quality reports required by the contract.

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.
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