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.
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 MediCal
Grade
26
Work Experience - Required
Healthcare, Quality
Work Experience - Preferred
Education - Required
Bachelors - Healthcare
Education - Preferred
Masters - Behavioral Health
License and Certifications - Required
License and Certifications - Preferred
LSW - Licensed Social Worker - Care Mgmt
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.
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.
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 (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .
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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.
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