Clinical Quality Specialist

The ideal candidate will have two or more years of experience in a managed care organization (MCO) as well as two or more years experience in healthcare quality improvement.

Independently performs quality functions within the Quality Department of a Care Center or office. Coordinates projects resulting in continuous quality improvement and process improvement. Supports the maintenance of a strong quality program, measured processes and reported outcomes.

ESSENTIAL FUNCTIONS:
- Coordinates assigned quality and process improvement activities which may include accreditation support, process improvement projects, quality studies, CQI (continuous quality improvement) process training for staff, prevention program coordination, care coordination initiatives, satisfaction survey coordination and follow-up, provider and member advisory groups, tracking of adverse incidents. monitoring of performance guarantees, provider profiling support, and CAPs and customer related quality initiatives.
- Conducts quality control reviews and internal audits. Summarizes findings and prepare reports on findings. Assists in the preparation of customer audits.
- Conducts analyses of data findings for quality and process improvement and assists in report preparation for internal and external customers.
- Supports assigned quality committees and work groups through comprehensive project management ensuring that documentation is accurate and timely, agenda items presented and follow-up actions taken.

General Job Information

 

Title

Clinical Quality Specialist

Grade

20

Job Family

Quality Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

3/16/2018

Date Requisition Created

3/14/2018

Minimum Qualifications

Education

Bachelors Healthcare

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

- Knowledge of healthcare quality improvement processes and performance measurement. - Attention to detail and ability to work efficiently to meet deadlines and timelines. - High degree of organization required. - Expertise in data management, data analysis, reporting word processing, and project management skills-Strong working knowledge of Microsoft Excel, VISIO and MS Project1-3 years quality improvement and auditing or related in healthcare field.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled

Company
Magellan Health
Posted
09/02/2018
Type
Full time
Categories
Operations_QA
Location
Glen Allen, VA 23060, US