Senior Quality Manager-Magellan Health - Albuquerque, NM

Albuquerque NM 87113

Job Description

Job Summary
 
Conducts and oversees treatment record and case management record reviews. Trends and analyzes findings for internal and external reporting.

Essential Functions

br>- Reviews charts and analyzes clinical record documentation.
- Conducts ongoing activities which monitor established quality of care standards in the participating provider network and for other clinical staff.
- Collects, analyzes and prepares clinical record information for projects related to assessing the efficiency, effectiveness and quality of the delivery of managed care services. Prepares monthly performance reports.
- Assists in the planning and implementation of activities to improve delivery of services and quality of care including the development and coordination of in-service education programs for providers and other clinical staff.
- Provides training, interpretation and support for QI Clinical Reviewer staff.
- Responsible for auditing as well as validating internal audit results and/or corrective action plans.

General Job Information

Title

Senior Quality Manager-Magellan Health - Albuquerque, NM

Grade

27

Job Family

Quality Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

3/18/2019

Date Requisition Created

3/7/2019

Minimum Qualifications

Education

Masters: Healthcare (Required)

License and Certifications - Required

License and Certifications - Preferred

LSW - Licensed Social Worker - Care Mgmt

Other Job Requirements

Responsibilities

-Licensed Masters level social worker, or Licensed Bachelors level RN. -Experience in working with total quality improvement or behavioral healthcare background in treatment modalities, psychopharmacology, federal/state regulatory guidelines, performance measurement. -Ability to work independently with minimal supervision.

-Masters level clinician.-Managed behavioral health and accreditation processes.-Ability to quickly develop an alliance with providers via telephone.

5 years healthcare quality improvement

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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