Manager, Quality Management

Manager, Quality Management
Wheeling, WV
Full-Time
Quality
Director, Clinical Quality

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. 

  1. Degree in Public Health, Health Administration, Registered Nursing, or other health related field.
  2. Experience in monitoring NCQA requirements in a health plan setting.
  3. Advanced knowledge of Microsoft Office applications including Excel and Word.
  4. Ability to plan, execute and complete long-term projects.
  5. Experience with automated information systems and computer generated data.
  6. Strong public speaking and written communication skills.
  7. Ability to work independently as well as part of a team.
  8. Working knowledge of how to perform compliance audits.
  9. Supervisory and management experience.

  1. Certified Coder.
  2. Working knowledge of grievances, complaints and appeals processes.
  3. Working knowledge of HEDIS measures.

Employment Documents

EEO

Or, if you are interested in a fast-paced career with us, please send resume with salary requirements to:

HR Department 
1110 Main Street
Wheeling, WV 26003-2704
hr@healthplan.org