Quality Manager - Chicago, United States - Acentra Health

Acentra Health

Verified Company

Chicago, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

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 healthrelated field
Solutioning and problemsolving 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
Indepth 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

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 healthrelated field

required

Solutioning and problemsolving 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."_