Sr Quality Manager – Behavioral Health
National Health Plan seeks a Sr. Quality Manager to manage a quality team and quality initiatives for the company’s Behavioral Health managed care business. The Sr. Quality Manager will manage the design, implementation and monitoring of quality programs for the behavioral health managed care business
- Work collaboratively with other national directors to ensure projects are within scope and meet time, budgetary and regulatory requirements.
- Develop state work plans, revising as appropriate to meet state, regulatory and accreditation requirements
- Review health plan deliverables for accuracy and state, regulatory and accreditation requirements
- Develop, implement and monitors the quality management program description, work plan, and program evaluation, including assessment of compliance with state, contractual, regulatory and accreditation requirements
- Implement and modify as needed, the health plan’s quality management policies and procedures to meet state, regulatory and accreditation requirements
- Manage a team of 2 direct reports.
- BS / MS preferred
- CA license: BCBA or LCMFT or LCSW or LMPH or LPC or RN
- A strong background in behavioral health in a managed care environment
- 5+ of healthcare quality improvement
- Strong working knowledge of quality improvement processes, performance measurement, accreditation standards, measurement tools, CQI tools, audit processes 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.
- Knowledge of NCQA and URAC standards.
- Knowledge of statistical analysis procedures and software.