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Manager, Quality MediCal

Company: Magellan Health
Location: Rancho Cordova
Posted on: May 4, 2022

Job Description:

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 RequirementsResponsibilities5+ 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 InformationTitleManager, Quality MediCalGrade26Work Experience - RequiredHealthcare, QualityWork Experience - PreferredEducation - RequiredBachelors - HealthcareEducation - PreferredMasters - Behavioral HealthLicense and Certifications - RequiredLicense and Certifications - PreferredLSW - Licensed Social Worker - Care MgmtMagellan 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.

Keywords: Magellan Health, Rancho Cordova , Manager, Quality MediCal, Executive , Rancho Cordova, California

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