Senior Quality Manager-Magellan Health - Albuquerque, NM

Company: Magellan Health

General Information
US-NM-Albuquerque
N/A
Not Specified
Full-Time
Not Specified
None
False
False
Job Description Job Summary
 
Conducts and oversees treatment record and case management record reviews. Trends and analyzes findings for internal and external reporting.
Essential Functions
- Reviews charts and analyzes clinical record documentation.
- Conducts ongoing activities which monitor established quality of care standards in the participating provider network and for other clinical staff.
- Collects, analyzes and prepares clinical record information for projects related to assessing the efficiency, effectiveness and quality of the delivery of managed care services. Prepares monthly performance reports.
- Assists in the planning and implementation of activities to improve delivery of services and quality of care including the development and coordination of in-service education programs for providers and other clinical staff.
- Provides training, interpretation and support for QI Clinical Reviewer staff.
- Responsible for auditing as well as validating internal audit results and/or corrective action plans.

General Job Information

 

Title

Senior Quality Manager-Magellan Health - Albuquerque, NM

Job Family

Operations_QA

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

5/9/2017

Date Requisition Created

5/9/2017

Minimum Qualifications

Education

Bachelors, MastersBachelors: Nursing (Required), Masters: Social Work (Required)

License and Certifications

LSW - Licensed Social Worker - Care Mgmt

Other Job Requirements

Responsibilities

5 years 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., Managed behavioral health and accreditation processes. Knowledge of accreditation standards related to the book of business.

Competencies

Language(s)

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled

Job Requirements