Manager, Quality Improvement Health Integrated
THIS JOB HAS EXPIRED Description
JOB SUMMARY: The Manager of Quality Improvement and Accreditation is responsible for assisting the Vice President of Quality Improvement with the development and implementation of an organization-wide quality improvement program that will effectively monitor, improve and advance the quality of care and service goals of Health Integrated and its customers. This will include monitoring and ensuring compliance with all accreditation and regulatory requirements. The Manager will have primary responsibility for promoting and managing the day-to-day clinical and service quality improvement initiatives throughout the Health Integrated organization. The Manager supports the development, coordination, implementation and evaluation of continuous quality improvement and organizational excellence in areas of quality of care and service, compliance, key performance indicators, and provider and member satisfaction.
Education/License/Certification: Licensed professional in healthcare field with current unrestricted license (RN, LCSW, LMHC); BSN, BA, or BS required. Masters level preferred. Additional certification in specialty fields or other advanced certification preferred. Certified Professional in Health Care Quality (CPHQ) preferred.
Experience: At least 5-7 years experience in Quality Improvement. Three years management level experience preferred. Three or more year?s direct patient care in an inpatient and/or outpatient medical and/or behavioral healthcare setting and Managed Care experience is required. Working knowledge of NCQA & URAC accreditation experience required. Behavioral Health experience desired.
Proficiency in software applications including: MS Word, MS Excel, and MS Power Point. Current broad-based expertise in managed care, quality improvement processes, URAC and NCQA accreditation standards, and state and federal guidelines in healthcare. Sound leadership skills and ability to interact effectively with physicians, operational and clinical staff, peers, Senior Management and other business leaders. Ability to develop and facilitate interdepartmental teams within the organization. Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand. Effective problem solving skills with the ability to systematically analyze problems, draw appropriate conclusions and develop relevant courses of action. Strong statistical and analytical skills with knowledge of CQI concepts, implementation and evaluation. Hands-on experience with writing and implementing policies and procedures to support QI processes including accreditation and/or regulatory compliance.
Assists the Vice President, Quality Improvement and Accreditation with advancing the QI program objectives by coordinating and monitoring QI activities with department lead persons
Coordinates activities to support client health plan quality programs by developing internal processes and ongoing monitoring activities
Documents, develops and/or coordinates corrective action plans in response to clients, accreditation agencies or regulatory bodies
Identifies, designs and implements quality initiatives to evaluate and improve member care and service quality, including member safety initiatives
Assists the Vice President, Quality Improvement and Accreditation with coordinating the activities of the Health Integrated Quality Improvement Committee (HIQIC)
Actively participates on the HIQIC by providing regular reports on the status of QI activities and overseeing the reporting of QI staff
Monitors and identifies changes in or new accreditation requirements and communicates those requirements to appropriate individuals/departments
Integrates new and revised accreditation standards into Health Integrated policies, procedures and processes; and facilitates organization-wide accreditation preparations
Utilizes CQI skills in data analysis to identify significant and problematic issues; develops and implements improvement plans
Evaluates QI initiatives against established targets and goals to identify trends, barriers, opportunities and improvement actions
Supports the QI staff in the administration of member and practitioner satisfaction surveys, including data analysis, improvement plans and the corresponding client reports
Supports operational objectives of quality and process improvement by organizing the necessary teams, utilizing the appropriate tools and process measures to improve member clinical and service goals
Assists the Vice President, Quality Improvement and Accreditation and the QI Staff with coordinating the Annual Evaluation of the effectiveness of the Quality Improvement program
Supports the development and implementation of the annual Quality Improvement Program Description, and Corporate QI Work Plan
Participates in client pre-delegation and ongoing delegation assessments to ensure compliance with accreditation, regulatory and client requirements
Supports the Vice President, Quality Improvement and Accreditation in the development, implementation and monitoring of policies, procedures and processes to support compliance with accreditation and regulatory requirements
Manages performance of QI staff, including the mentoring and professional development of the QI staff
Performs other duties as indicated by the VP of Quality Improvement and Accreditation
||10008 North Dale Mabry |
Tampa, FL 33618
THIS JOB HAS EXPIRED