Senior Quality Specialist - Healthcare
San Diego CA 92108
Job DescriptionServes as a member of the quality team at the national, regional or unit level. Coordinates projects resulting in continuous quality improvement and process improvement. Supports the maintenance of a strong quality program, measured processes including HEDIS (where applicable) and reported outcomes.
- Serves as QI specialist for the quality program with the goal to meet customer requirements and performance guarantees. Duties include coordinating Quality/ Accreditation/Delegated initiatives and project plans, monitoring and execution to meet timely deliverables.
- Provides direct interventions with members and providers to address gaps in care.
- Develops, in collaboration with the customer and communication department, informational and training materials for providers and members.
- Coordinates with any vendors outreach and interventions.
- Prepares status reports on activities and outcomes of interventions and activities.
- Consults and trains staff on measurement specifications.
- Provide assistance as needed in data maximization efforts through coordination with the company's Central HEDIS team.
- Coordinates CQI (continuous quality improvement) processes and studies related to improved outcomes.
- Provides interface with customers, National Quality/Clinical and CCOE staff for HEDIS planning, reporting and program enhancements.
CA State Behavioral Health Licensure
General Job Information
TitleSenior Quality Specialist - Healthcare
Job FamilyQuality Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date1/8/2019
Date Requisition Created1/7/2019
EducationBachelors: Healthcare (Required), Masters: Healthcare
License and Certifications - Required
License and Certifications - PreferredRN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt
Other Job Requirements
- Preferred Qualifications: RN with behavioral health experience or behavioral health licensed clinician.
- 1-3 years of quality improvement and auditing or related in healthcare field.
- 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 Project.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled
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