Quality Manager

2 weeks ago

Sanford, United States True Health Full time
Job Description: Quality Manager

Job Summary

True Health’s Quality Manager is primarily responsible for the daily operations of the care coordination and case management teams. This position ensures that program practices are consistent with established standards, procedures, and requirements. The Quality manager will identify and implement opportunities to improve health care quality and patient satisfaction.

Essential Functions

Oversee and monitor quality improvement activities and promote improvement of quality measures while remaining in compliance with all required regulations. Direct oversight of care coordination and case management team members. Oversee and manage an integrative system of care coordination. Initiate and oversee ongoing quality improvement practices. Meet with insurance company representatives regularly to review quality metrics and outline areas of opportunity with a plan of action. Monitor quality performance and identify activities to further enhance the quality of care. Monitor call queue metrics, bucket reports, and other necessary reports needed to ensure efficiency within the department. Participate in regular meetings with insurance companies, external partners, departmental and company-led meetings, as requested. Maintain departmental policies, procedures along with standard operating procedures as defined by company policy and procedures. Coordinate with the Chart Auditor, Quality Data Specialist and EMR Trainers to develop audit systems, perform data analysis and prepare reports related to measuring objectives and tracking outcomes as required by grants, or contracts. Analyze and report data, as required, in conjunction with the QI Reporting calendar and for continued recognition through AAAHC and HRSA UDS. Coordinate with Quality Director, Medical Directors, CNO, Clinical Directors as well as members of Management to organize and lead chronic disease care improvement efforts. Collaborate with Director of Quality and Medical Directors to develop new or update existing clinical outcome measures, protocols, policies and procedures to ensure compliance with policies through a peer review process

Education and Experience

Completion of accredited Registered Nursing (RN) program with current Florida RN license active and in good standing. Bachelor’s degree in nursing is preferred. Five (5) years of management experience in a related program area.

Knowledge, Skills, and Abilities

Demonstrated experience working with community-based organizations, consumers, and others. community stakeholders. Effective written, verbal, and electronic communication skills. Knowledge of Microsoft Suite and Windows-based applications. Aptitude to interpret, present and explain basic public health data and statistics. Effective in development and implementation of work plans and timelines. Ability to manage complex tasks and meet deadlines. Demonstrated commitment to health equity. Foster and maintain teamwork. Ability to effectively communicate with healthcare teams. Good organizational skills to handle multiple priorities while remaining professional and calm Ability to work well with others. Competent in prioritizing, and organized, while carrying out work assignments independently and efficiently in addition to being self-directed and flexible. Must be able to make suggestions on workflow or system efficiency and effectiveness. Ability to build and motivate teams with demonstrated leadership and facilitation experience. Travel required.

Additional Qualifications

Experience working with diverse communities, organizations and agencies preferred. Bilingual (English/Spanish) a plus. Must have reliable transportation.

Relationship Reporting

Reports to Director of Quality

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