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Director, Quality - PHP

Company: Magellan Health
Location: Albuquerque
Posted on: September 13, 2020

Job Description:

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 processes.

- 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

Responsibilities

5-8 years of experience with management level and supervisory experience

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

Work Experience

Management/Leadership, Quality Education

Masters: Healthcare (Required) License and Certifications - Required

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 position.

Posted 2 Days Ago

Full time

R00000036894

About Us Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive. Click here to search our openings.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. “Interviews” are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Keywords: Magellan Health, Albuquerque , Director, Quality - PHP, Other , Albuquerque, New Mexico

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