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. ESSENTIAL FUNCTIONS: - 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. General Job Information TitleDirector, Quality
Newtown, PA Grade29 Job FamilyQuality Group CountryUnited States of America FLSA StatusUnited States of America (Exempt) Recruiting Start Date5/1/2018 Date Requisition Created5/1/2018 Minimum Qualifications EducationMasters: Healthcare (Required) License and Certifications
Required License and Certifications
Preferred Other Job Requirements Responsibilities5 ? 8 years of experience with management level and supervisory experience? Clinical degree ? Knowledge of NCQA and URAC standards. ? Knowledge of statistical analysis procedures and software.? 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. Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled
Magellan Health Services