Responsible for all aspects of the quality program for a
business unit within a SBU including strategic planning, program
development and leadership, and staffing. Serves as a member of the
management team in designing, implementing, and monitoring quality
operations. Responsible for performance measurements and analytics,
customer reporting, client delegation activities, policies and
procedures, quality of care concerns tracking, accreditation
preparation, coordination of satisfaction surveys, performance
guarantee tracking, integration of quality improvement processes
and compliance oversight. - Directs and supervises quality staff
and projects to meet unit goals for the quality program, including
the monitoring of policies, procedures, activities, to meet
multiple contractual requirements, external accreditation, and
state and federal regulations.
- Ensures that studies and activities are conducted with
appropriate feedback from customer organizations, assigned
departments, and member and provider input.
- In consultation with assigned business unit leadership, sets
priorities for improving operations based on data from performance
indicators, delegation audits, and quality improvement
- Serves as liaison with department managers to ensure that
needs are met for internal and external reporting and analytics and
the development of decision support tools.
- Oversees internal and external audit procedures to meet
customer requirements, accreditation standards and goals of the
assigned business unit.
- Serves as co-chair of the unit's Quality Improvement Committee
and provides oversight of committee documentation.
- Assists Learning Department in development and presentation of
CQI and compliance training programs for staff and customers.
Other Job Requirements
5-8 years of experience with management level and supervisory
Knowledge of quality improvement processes, performance
measurement, accreditation standards, measurement tools, CQI tools
and data reporting applications.
Knowledge of CQI training and QIA methodology.
Demonstrated management and leadership skills.
Expertise in data management software including spreadsheet
development and use.
Master's degree in Healthcare/Clinical field
Knowledge of NCQA and URAC standards.
Knowledge of statistical analysis procedures and software.
General Job Information
Management/Leadership, Quality Education
Masters: Healthcare (Required) License and Certifications -
License and Certifications - Preferred
Magellan Health Services is proud to be an Equal Opportunity
Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every
employee must understand, comply and attest to the security
responsibilities and security controls unique to their
Posted 2 Days Ago
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