Manager, Quality Management
Responsible for assisting in the oversight and coordination of the Quality Program.
Assist in coordination of NCQA/External Quality Review Organization activities and accreditation.
Assist the Director, Clinical Quality in the coordination and oversight of all Quality Management & Quality Improvement components to meet accrediting standards and regulations.
- Degree in Public Health, Health Administration, Registered Nursing, or other health related field.
- Experience in monitoring NCQA requirements in a health plan setting.
- Advanced knowledge of Microsoft Office applications including Excel and Word.
- Ability to plan, execute and complete long-term projects.
- Experience with automated information systems and computer generated data.
- Strong public speaking and written communication skills.
- Ability to work independently as well as part of a team.
- Working knowledge of how to perform compliance audits.
- Supervisory and management experience.
- Certified Coder.
- Working knowledge of grievances, complaints and appeals processes.
- Working knowledge of HEDIS measures.