- Consult with network physicians, providers, members, and other resources, as appropriate, to assess, plan, facilitate implement, coordinate, monitor and evaluate options to meet clinical quality improvement project/auditing/reporting objectives and to promote high quality and cost-effective outcomes.
- Gather information, analyzes and communicates it, and develops recommendations regarding clinical quality improvement projects/audits/reports.
- Assist in addressing issues related to clinical quality improvement projects/audits/reports for the managed care programs to assure compliance with contractual arrangements, accreditation requirements, government regulations and employer group expectations.
- Assist in coordinating internal support functions for assigned clinical quality improvement projects/audits/reports.
- Analyze statistical reports to evaluate effectiveness of quality improvement projects, as well as to identify opportunities for improvement.
- Cooperate with other members of the department and interfacing departments as a team to increase overall efficiencies in an effort to maintain or decrease administrative costs.
- Provide ongoing documentation of clinical quality improvement project interventions for quarterly and annual quality improvement reports, and for accreditation reviews, ensuring reporting accuracy and timeliness.
- Present clinical quality improvement project results to quality improvement workgroups and the Behavioral Health QI Committee.
- Masters-level Behavioral Health Professional with independent practice license. License is current, valid in the state of operations and in good standing.
- 3 years clinical practice experience.
- 2 years Utilization Management, Case Management, quality improvement and/or project management experience.
- Experience conducting presentations for member and/or provider training.
- Knowledge of behavioral health or managed care products and programs.
- Current, unrestricted driving license.
- Ability to travel including overnight stays.
- Verbal and written communication skills.
- Data analysis experience.
- PC proficiency to include Word and Excel.
- Quality improvement and/or project management experience.
- Behavioral Health experience.
-
Specialist Management
4 days ago
SilverLinx Shady Shores, TX, United States FreelanceShady Shores, TX 'The Heilpädagogische Kinder and Jugendhilfe Rotenburg e.V. promotes the individual and social development of children, adolescents, and their families. We provide support for young people with behavioral problems, developmental disorders, and mental and physical ...
-
Contract Management Specialist
3 weeks ago
Boeing Company Richardson, TX, United StatesJob Description At Boeing, we innovate and collaborate to make the world a better place · From the seabed to outer space, you can contribute to work that matters with a company where diversity, equity and inclusion are shared values · We're committed to fostering an environment f ...
-
Talent Management Specialist
3 weeks ago
Lennox Richardson, United StatesCompany Overview: · Lennox (NYSE: LII) is an industry leader in energy-efficient climate-control solutions founded over a century ago on the principles of integrity and innovation. Dedicated to sustainability and creating comfortable, healthier environments for our residential a ...
-
logistics management specialist
3 weeks ago
Army National Guard Units Fort Richardson, United StatesSummary Opened Area(s) of Consideration: 1, 2, 3 DEFINITION OF AREA(S) OF CONSIDERATION: Area 1 - AKNG Permanent or Indefinite technicians. Area 2 - All AKNG members. Area 3 - All other current military members who are eligible to join the Alaska Army National Guard. PDCN: D Sele ...
-
Vulnerability Management Specialist
5 hours ago
HARMAN International Richardson, United States Full timeA Career at HARMAN · As a technology leader that is rapidly on the move, HARMAN is filled with people who are focused on making life better. Innovation, inclusivity and teamwork are a part of our DNA. When you add that to the challenges we take on and solve together, you'll disc ...
-
Contract Management Specialist
4 days ago
Neptune Enterprises Denton, TX, United States FreelanceMySpeyer · App · **Administrative Assistant** · **Contract Management (m/f/d)** · We are currently seeking a motivated individual to join our team as an Administrative Assistant for Contract Management at our location in Denton, TX. · **Interested?** · Please send us your applica ...
-
Logistics Management Specialist
6 days ago
U.S. Army Cyber Command Fort Richardson, United States Full timeWorks closely with the battalion Safety Officer to ensure compliance with the unit Hazardous Communication Program (HAZCOM). · Manages battalion HAZMAT/HAZWASTE program. · Responsible for ensuring organizational compliance with all federal, state, and local regulatory requirement ...
-
Wire Transfer Specialist
2 weeks ago
PROSPERITY BANK Richardson, United States Full timeThe Wire Transfer Specialist is responsible for receiving, verifying and processing incoming and outgoing domestic, international and foreign currency wire transfers and to complete miscellaneous assignments as requested. · - **ESSENTIAL FUNCTIONS AND BASIC DUTIES** · **Assumes r ...
-
Network Management Contract Specialist
3 weeks ago
Health Care Service Corporation Richardson, United StatesAt HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career. · Come join us and be part of a purpo ...
-
supervisory logistics management specialist
2 weeks ago
Army National Guard Units Fort Richardson, United StatesSummary Opened Area(s) of Consideration: 1, 2, 3 DEFINITION OF AREA(S) OF CONSIDERATION: Area 1 - AKNG Permanent or Indefinite technicians. Area 2 - All AKNG members. Area 3 - All other current military members who are eligible to join the Alaska Army National Guard. PDCN: D Sele ...
-
supervisory housing management specialist
1 week ago
Pacific Air Forces Fort Richardson, United StatesSummary Click on "Learn more about this agency" button below to view Eligibilities being considered and other IMPORTANT information. The primary purpose of this position is to serve as first level supervisor, providing planning, directing, organizing, and exercising control over ...
-
Phoenix Innovations Ovilla, United StatesTraining as a Digitalization Management Specialist (m/f/d) at EUROVIAJoin the EUROVIA team · We shape infrastructure. With over 140 locations nationwide and more than 3,800 employees, EUROVIA is one of the leading construction companies in Germany. We cover the entire value chain ...
-
FusionWorks Mesquite, United StatesYour area of responsibilityPlanning, adaptation and implementation of information and telecommunications systems · Training and support for IT solutions · Implementation of quality measures · Monitoring and implementation of data security · Commercial review of product portfolio ...
-
Dual Study: Computer Science
4 days ago
Crimson Solutions Richardson, United StatesRichardson Informatik (B.Sc.) at Siemens Healthineers · • Erlangen · • Dual Study ProgramYour Job Description:Are you interested in diving into the world of computer science at Siemens Healthineers? Then apply now for our dual study program in computer science (B.Sc.). At our c ...
-
Human Resources Officer
4 days ago
Neptune Enterprises Richardson, TX, United States Freelance**HUMAN RESOURCES REPRESENTATIVE (M/F/D) Part-Time** · **NICE TO MEET YOU** · With over 15 years of experience in senior home care and over 150 locations nationwide, Home Instead continues to grow. Join our local team and use your personality and expertise to help provide assista ...
-
supervisory logistics management specialist
2 weeks ago
Department Of The Army Fort Richardson, United States Full timeSummary · Opened Area(s) of Consideration: 1, 2, 3 · DEFINITION OF AREA(S) OF CONSIDERATION: · Area 1 - AKNG Permanent or Indefinite technicians. · Area 2 - All AKNG members. · Area 3 - All other current military members who are eligible to join the Alaska Army National Guard. · ...
-
Behavioral Health Quality Management Specialist
2 weeks ago
Innovative Systems Group Richardson, United StatesWe are now looking for Behavioral Health licensed clinicians only (Cannot accept RN's or LPN's) · This is a part-time position, 20–25 hours a week. · This position is remote. · Contract: to · BASIC FUNCTION: · This position is responsible for facilitating all aspects of assigned ...
-
Innovative Systems Group Richardson, United StatesWe are now looking for Behavioral Health licensed clinicians only (Cannot accept RNs or LPNs) · This is a part-time position, 20–25 hours a week. · This position is remote. · Contract: to · BASIC FUNCTION: · This position is responsible for facilitating all aspects of assig ...
-
Innovative Systems Group Richardson, United StatesWe are now looking for Behavioral Health licensed clinicians only (Cannot accept RNs or LPNs) · This is a part-time position, 2025 hours a week. · This position is remote. · Contract: to · BASIC FUNCTION: · This position is responsible for facilitating all aspects of assign ...
-
Nexus Dynamics La Prairie, United StatesDo you love being able to help people in your nursing profession and value the joy of work? · ▸ If a respectful work environment is important to you · ▸ If you are looking for a strong team and a good working atmosphere · ▸ If appreciation and recognition motivate you · ▸ If a ba ...
Behavioral Health Quality Management Specialist - Richardson, United States - Innovative Systems Group
Description
We are now looking for Behavioral Health licensed clinicians only (Cannot accept RN's or LPN's)
This is a part-time position, 2025 hours a week.
This position is remote.
Contract: to
BASIC FUNCTION:
This position is responsible for facilitating all aspects of assigned clinical quality improvement projects, quality auditing, quality reporting; consults with physicians, providers, members, and other resources, as appropriate, to assess, plan, facilitate implement, coordinate, monitor and evaluate options and services required to meet clinical quality improvement project/audits/reporting objectives; uses available resources to promote high quality and cost-effective outcomes. This position is responsible for coordinating quality reviews, audits, and projects in compliance with accreditation and regulatory agency requirements.
ESSENTIAL FUNCTIONS:
1. Perform on-site or electronic medical record reviews to evaluate delivery of care in relation to clinical practice guidelines or state regulations.
2. Responsible for facilitating and monitoring of assigned quality improvement projects, including the following:
3. Coordinate and provide interface with Behavioral Health providers and other practitioners, as well as the state, regarding existing and proposed clinical quality improvement initiatives and results.
4. Assist in development, implementation, and evaluation of effectiveness of population-based programs. Participate in activities such as literature review to identify appropriate recommendations for quality improvement initiatives, population assessment, and development of data collection tools.
5. Facilitate action plan activities related to assigned programs, coordinate with internal and external resources to meet program targets and objectives.
6. Assist in preparing accurate reports and program documents including, but not limited to, the QI Program Description, QI Work Plan, and Program Evaluation.
7. Assist in meeting and interfacing with outside agencies and organizations such as Illinois Department of Public Health, American Academy of Pediatrics, American Diabetes Association, various state departments, etc.
8. Attend internal/external meetings to keep apprised of quality improvement and managed care issues/information.
9. Maintain and enhance knowledge of clinical and regulatory standards by attending seminars, training sessions, etc.
10. Performs ongoing monitoring of quality of care and/or critical incidents to assure compliance with accreditation and regulatory requirements.
11. Assist in day-to-day activities to achieve HCM or GPD annual divisional goals, as appropriate.
12. Practice within the scope of licensure and/or certification and accreditation standards.9. Communicate and interact effectively and professionally with co-workers, management, customers, etc.
13. Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
14. Maintain complete confidentiality of company business.
15. Maintain communication with management regarding development within areas of assigned responsibilities, and perform special projects as required or requested.
JOB REQUIREMENTS:
PREFERRED JOB REQUIREMENTS:
Behavioral Health Quality Management Specialist professionals in Richardson
-
Shameka Scales
Operations Manager/Administrative Assistant
-
Mahammad Abasgulu
Sr SDET | Test Automation Engineer