About this role
This position will be responsible for HEDIS and NCQA Accreditation.
Responsible for assigned areas of quality within a specified unit of a SBU. Implements assigned quality program components. Interfaces with customers and regulatory entities. May have accreditation responsibilities based on contract requirements. • Manages day-to-day quality activities ensuring program and procedures support company goals for service, quality, and cost effectiveness as well as compliance with contract, federal and state requirements. Activities and projects may include interfacing with customers on quality programs. • Supervises quality staff to ensure successful execution of projects and initiatives. • Conducts training sessions on Continuous Quality Improvement (CQI) processes. • Coordinates quality initiatives. • Coordinates satisfaction survey and follow-up. • Coordinates Advisory Groups. • Tracks adverse incidents and Quality of Care concerns. • Monitors performance measures. • Supports provider profiling. • Audits for quality control. • Conducts quality studies and manages quality improvement projects. • Prepares customer and site reports with assistance from Reporting and Analytics team. • Participates on quality committees to ensure quality issues are taken to the committee and recommendations are made, by the committee, in a timely manner. Makes recommendations to the Committee for improving plan operations based on data from performance indicators, QI studies, and quality activities. • Serves as liaison with assigned departments to ensure quality projects are integrated within operations. • Conducts internal audits of charts and clinical/service procedures for quality purposes.
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.
Other Job Requirements
Responsibilities 5+ years of 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.
General Job Information
Title Manager, Quality- Remote
Grade 27
Work Experience - Required Healthcare, Quality Work Experience - Preferred
Education - Required Bachelor's - Healthcare Education - Preferred Master's - Behavioral Health License and Certifications - Required
License and Certifications - Preferred LSW - Licensed Social Worker - Care MgmtCare Mgmt Salary Range Salary Minimum: $77,785Salary Maximum: $124,455 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.
This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.