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Quality Director, HMSA

4 months ago

Honolulu, Hawaii, United States Magellan Health Full time
Responsible for all aspects of the quality program for a business unit within a Strategic Business Unit (SBU) including strategic planning, program development and leadership, and staffing. Serves as a member of the management team in designing, implementing, and monitoring quality operations with well defined processes and uses performance measurement as the foundation for quality and process improvements. Responsible for performance measurements and analytics, customer reporting, client delegation activities, policies and procedures, quality of care concerns tracking, accreditation preparation, coordination of satisfaction surveys, performance guarantee tracking, integration of quality improvement processes and compliance oversight. Represents the quality program to customers and regulatory entities on quality operations and performance achievement.
  • Directs and supervises proactively the quality department and projects to meet unit goals for the quality program, including the monitoring cost effectiveness, policies, procedures, activities, to meet multiple contractual requirements, external accreditation, and state and federal regulations.
  • Ensures that quality improvement studies and activities are conducted with appropriate feedback from customer organizations, assigned departments, and member and provider input.
  • In consultation with assigned business unit leadership, sets priorities for improving operations based on data from performance indicators, delegation audits, and quality improvement processes.
  • Serves as liaison with department managers to ensure that needs are met for internal and external reporting and analytics and the development of decision support tools.
  • Oversees internal and external audit procedures to meet customer requirements, accreditation standards and goals of the assigned business unit.
  • Serves as co-chair of the unit's Quality Improvement Committee and provides oversight of committee documentation (as applicable).
  • Assists Learning Department in development and presentation of CQI and compliance training programs for staff and customers.

Other Job Requirements

Responsibilities

8+ years of experience in quality.
3+ years of experience in management/leadership.
Knowledge of quality improvement processes, performance measurement, accreditation standards, measurement tools, CQI tools 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.
Must be skilled at mastering new areas of content and operations.
Excellent written and verbal communication skills required.

General Job Information

Title

Quality Director, HMSA

Grade

29

Work Experience - Required

Healthcare, Management/Leadership, Quality

Work Experience - Preferred

Education - Required

Bachelor's, Bachelor's - Healthcare

Education - Preferred

Master's - Healthcare

License and Certifications - Required

License and Certifications - Preferred

LCSW - Licensed Clinical Social Worker - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, LSSBB - Lean Six Sigma Black Belt Certification - Enterprise, LSSGB - Lean Six Sigma Green Belt Certification - Enterprise

Salary Range

Salary Minimum:

$93,955

Salary Maximum:

$159,725

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.