Overview
Quality Manager Jobs in Santa Fe Springs, CA at Central Neighborhood Christian Health Clinics
Full Job Description
SUMMARY:
The Quality Manager supports the development and implementation of quality assurance
measurements and audits. Assists in improving medical management processes throughout the
clinics through coordinating and engaging in activities to proactively promote implementation
of evidence based best practices and resolve deficiencies.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Lead specific groups and present findings to the CMO, senior leadership and various committees.
Perform ongoing analysis of gaps in clinical care and barriers to care; ensuring alignment of all interventions with the HEDIS and NCQA strategic plan.
Design and implement quality improvement studies including selection of valid and reliable indicators.
Coordination, monitoring and evaluation of medical record reviews.
Assess care opportunities, designing and implementing member and provider specific actions or interventions.
Develop strong working relationships with all departments and divisions, physicians and non-physician providers and allied health care organizations.
Coordinate and lead functional areas to achieve national accreditation.
Oversee, coordinate and implement regulatory activities and site reviews as required, including Medicaid, Medicare and other EQRO’s.
Implement quality improvement activities based upon outcomes for internal and external
Quality Management within the Health Services clinical division.
Manage the clinical quality management program.
Ensure all departments comply with and understand the quality program, reporting elements and regulatory requirements.
Actively collaborate with Plan and/or Corporate teams to improve sustainable member outcomes.
Educate providers and other organizational departments in the improvement of member outcomes and satisfaction for assigned population(s).
Conduct audits for all nationally delegated vendors and provider office visits to facilitate ongoing education and improvement for assigned populations.
Organize quality staff participation in provider office clinic days, health fairs and community events to ensure maximum member benefit, improved data collection and display a clinical presence.
Knowledge of medical risk management.
Complete all other duties as assigned.
QUALIFICATION REQUIREMENTS:
To perform this job successfully an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION AND/OR EXPERIENCE:
Degree in Nursing
Licensed Vocational Nurse required.
3-5 years of Managed Care experience.
KNOWLEDGE, SKILLS, and ABILITIES:
Experience in the health care field with a concentration in Quality Management.
Leadership skills with the ability to direct activities of others, both individually and within a project team setting.
Excellent verbal and written communication skills.
Excellent organizational skills and attention to detail.
Ability to work independently and possess strong time management skills.
Title: Quality Manager
Company: Central Neighborhood Christian Health Clinics
Location: Santa Fe Springs, CA
Category:
