Manager, Quality Management

Company: Beacon Health Options ( Learn More )

General Information
US-KY-Louisville
N/A
4 Year Degree
Full-Time
At least 5 year(s)
Not Specified
False
False
Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Manager, Quality Management. The Manager, Quality Management will be responsible for overseeing the internal and external quality activities, operationalizing the quality management program, participating and coordinating the regional and corporate Quality Management activities.  

The incumbent in this position can work remotely from any location and will be responsible for the KY, WV and VA markets.

Position Responsibilities:

  • Management of quality department requirements, including assuring the timely completion of all contract deliverables.  Analysis of current processes and development of new or revised workflow documents for quality programs to improve efficiency, accuracy and compliance.
  • Serve as the primary lead in the development, operationalization and evaluation of Local/ Regional Quality Management plan.  In collaboration with the Director Quality Management, develops and implements an annual Quality Program documents (i.e. Work Plan and Evaluation).
  • Assume primary responsibility for maintaining NCQA and URAC accreditation.  Contribute and participate in preparation and audits for accreditation through national credentialing bodies such as NCQA or URAC.
  • Interface with external and internal customers to ensure ongoing quality improvement activities, accreditation requirements, and prevention programs. 
  • Supervise the Quality Specialists/Analysts (as directed).  Supervise and evaluate performance of quality management staff. Approve leave requests, time sheets and other documents as appropriate.  Mentor staff to meet professional potential.  Monitor performance and conducts timely annual performance appraisals; assesses training needs and coordinate resources to ensure performance and training issues are addressed timely.  Keep Director apprised of staff progress and significant issues and needs.
  • Position Requirements:

    Education: Bachelor’s Degree required. Master’s degree in health related field or 5 years’ experience in a health related field preferred.

    Licensure:  Licensure in a mental health related field (Ph.D., RN, LCSW, ACSW, etc.) preferred. Certification in health care quality program preferred.

    Relevant Work Experience:   Five years managed care experience, preferably in quality management.  Prior experience in a clinical behavioral health setting desirable.  Two years’ supervisory experience preferred.  Excellent verbal and written communication skills, strong analytical and organizational abilities. 

    Knowledge, Skills & Abilities:

  • Ability to work independently in an interdisciplinary setting and coordinate quality management/utilization management initiatives with various departments
  • Excellent verbal and written communication skills; strong analytical and organizational abilities.
  • Evidence of knowledge in the concepts, principles and practical applications of quality management initiatives (i.e., indicator development, bench marking and outcomes.)
  • Familiarity with utilization management, preferably in a managed care setting, required.
  • Evidence of project management experience required.
  • Familiarization with HIPAA and risk management practices preferred.
  • Basic computer skills required, including Word, PowerPoint, Access and Excel to create and review reports.
  • TO APPLY

    Click below on “Apply for this Position” to create a profile and apply for the position

    Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled

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