Senior Behavioral Health Quality Specialist

Magellan Health
Full time
Business Management
United States
Hiring from: Anywhere

Senior Behavioral Health Quality Specialist – Remote


Location United States, United States Minor Outlying Islands, 99999 Category Quality Job Id R00000036158


Candidates with experience in Behavioral Health and Medicaid are strongly preferred


Serves as a member of the quality team at the national, regional or unit level. Coordinates projects resulting in continuous quality improvement and process improvement. Supports the maintenance of a strong quality program, measured processes including HEDIS (where applicable) and reported outcomes.



  • Serves as QI specialist for the quality program with the goal to meet customer requirements and performance guarantees. Duties include coordinating Quality/ Accreditation/Delegated initiatives and project plans, monitoring and execution to meet timely deliverables.

  • Provides direct interventions with members and providers to address gaps in care.

  • Develops, in collaboration with the customer and communication department, informational and training materials for providers and members.

  • Coordinates with any vendors outreach and interventions.

  • Prepares status reports on activities and outcomes of interventions and activities.

  • Consults and trains staff on measurement specifications.

  • Provide assistance as needed in data maximization efforts through coordination with the company’s Central HEDIS team.

  • Coordinates CQI (continuous quality improvement) processes and studies related to improved outcomes.

  • Provides interface with customers, National Quality/Clinical and CCOE staff for HEDIS planning, reporting and program enhancements.


Education



  • Bachelors: Healthcare (Required), Masters: Healthcare


License and Certifications – Preferred



  • CPHQ – Certified Professional In Healthcare Quality – Care Mgmt, LSSBB – Lean Six Sigma Black Belt Certification – Enterprise, RN – Registered Nurse, State and/or Compact State Licensure – Care Mgmt

  • Experience in Lean Six Sigma.-MA in health care or related field.

  • Licensed clinician, RN.

  • CPHQ


Responsibilities



  • Knowledge of HEDIS/measurement specifications, accreditation standards and quality improvement processes.

  • Attention to detail and able to work efficiently to meet deadlines and timelines.

  • High degree of organization required.

  • Excellent verbal and written skills and the ability to enter data accurately into spread sheets and prepare professional looking documents and reports.

  • Expertise in data management, data analysis, reporting word processing, and project management skills.

  • 3-5 years quality improvement/HEDIS related experience


This job is expired. Please use the search form to find active jobs or submit your resume.


Post a resume

Similar jobs

Socialive is an enterprise video creation & live streaming software company based in El Segundo, California. Our powerful yet intuitive platform makes it refreshingly easy to capture, create, and distribute video. We empower teams across the organization, including marketing, internal...
Business Management
United States
Hiring from: Anywhere
Contrast Security
Full time
About this job Location options: RemoteJob type: Full-timeExperience level: ManagerRole: QA/Test DeveloperIndustry: Cybersecurity, Enterprise Software, Security SoftwareCompany size: 201–500 peopleCompany type: VC FundedTechnologies amazon-web-services, cloud, react-fullstack, testing Job description Contrast Security named to Inc.'s “Best Workplaces of 2020” Contrast Security...
amazon-web-services cloud react-fullstack testing
Business Management
United States
Hiring from: United States
Wikimedia Foundation, Inc.
Full time
About this job Location options: RemoteJob type: Full-timeExperience level: ManagerRole: Data ScientistIndustry: Education Technology, eLearning, Non-ProfitCompany size: 201–500 peopleTechnologies hadoop, bigdata, machine-learning Job description Summary The Wikimedia Foundation is seeking an experienced engineering leader to serve as Director of Data...
hadoop bigdata machine-learning
Business Management
No Location
Hiring from: Anywhere