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    Quality Manager - Chicago, United States - Acentra Health

    Acentra Health
    Acentra Health Chicago, United States

    2 weeks ago

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    Description

    Who we need:
    Acentra Health is seeking a Quality Manager to join our team.

    As the Quality Manager, you will be responsible for developing, implementing, and monitoring quality and performance improvement activities and clinical outcomes for our organization.

    You will play a key role in supporting both medical and behavioral health departments in delivering high-quality care.


    What you'll do:
    Lead and facilitate all Quality and Performance Improvement (QPI) activities across the organization
    Provide coaching and support to managers and staff regarding QPI
    Ensure the implementation of key performance indicators and maintain systems for tracking, reporting, and improving performance
    Assist in developing benchmarks for quality measures and outcomes
    Facilitate access to relevant policies, procedures, and resources for staff
    Promote awareness of customer requirements throughout the organization
    Participate in existing CQI activities, quality/outcome studies, and program development
    Lead local quality improvement committee and participate in clinical practice oversight committee
    Support quality of care reviews and assist in resolving member grievances or complaints
    Monitor and ensure staff have appropriate credentials and training
    Conduct audits of utilization and case management cases
    Monitor and report on quality indicators to identify opportunities for improvement
    Develop and maintain Quality Improvement Processes (QIPs) in alignment with regulatory requirements
    Evaluate program effectiveness and document quality metrics
    Review member satisfaction surveys and compare to performance indicators
    Report critical incidents to corporate compliance and assist with action plans
    Execute CQI plans to meet business requirements
    Participate in preparing quarterly and annual quality reports for clients
    Identify patterns and trends in clinical case and utilization management performance
    Maintain the Department's Quality Management Plan and Program Description
    Coordinate with Subject Matter Experts (SMEs) in developing clinical solutions
    Support commercial implementations and RFP/proposal processes for clients


    Requirements:
    Active unrestricted nursing license, or other applicable State and/or Compact State clinical licensure
    Bachelor's degree in nursing
    Formal training or certification in quality desired (CPHQ, ISO, Six Sigma)
    Quality management experience in a health-related field
    Solutioning and problem-solving experience in utilization and case management programs
    Minimum of 2 years case management experience
    Minimum of 1 year utilization management experience (preferred)
    Experience with commercial health plans and/or clinical programs (preferred)
    Knowledge of performance improvement strategies, principles, methodologies, techniques, and data analysis
    Ability to provide leadership, maintain confidentiality, and meet deadlines
    In-depth knowledge of CQI tools, methods, and techniques such as Six Sigma
    Excellent grasp and understanding of Statistical Process Control (SPC)
    Knowledge of URAC, NCQA, and/or ISO background (a plus)
    Strong analytical skills and ability to evaluate data objectively
    Excellent communication, organizational, presentation, and interpersonal skills
    Proficient in MS Office applications and internet/web navigation

    Requirements


    Qualifications:
    Active unrestricted nursing license, or other applicable State and/or Compact State clinical licensure required
    Bachelor's degree in nursing required
    Formal training or certification in quality desired (CPHQ, ISO, Six Sigma)
    Quality management experience in a health-related field required
    Solutioning and problem-solving experience in utilization and case management programs required
    Minimum of 2 years case management experience required
    Minimum of 1 year utilization management experience preferred
    Experience with commercial health plans and/or clinical programs preferred

    Benefits

    Benefits are a key component of your rewards package. Our benefits are designed to provide additional protection, security, and support for your career and life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

    Compensation

    The pay range for this position is $90,000-110,000

    "Based on our compensation philosophy, an applicant's placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."
    #J-18808-Ljbffr
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