Quality Specialist

Remote FL Orlando 32812

Remote position available

Job Description

Independently and collaboratively performs quality functions to support pharmacy distribution call center and operations team. Performs customer interaction audits and coordinates initiatives resulting in continuous quality improvement and process improvement. Supports the maintenance of a strong quality program within pharmacy distribution center with measured processes and reported outcomes.
  • Coordinates assigned quality and process improvement activities which may include accreditation support, process improvement projects, quality studies, CQI (continuous quality improvement) process training for staff, care coordination initiatives, satisfaction survey coordination and follow-up, provider and member advisory groups, tracking of adverse incidents, monitoring of performance guarantees,  CAPs and customer related quality initiatives.
  • Conducts customer interaction audits and leads calibration sessions with team supervisors to ensure consistency and integrity of call monitoring programs.
  • Summarizes findings and prepare reports on findings.
  • Works closely with members of pharmacy distribution leadership to develop process improvement initiatives with a goal of gaining operational efficiencies, protecting quality of work being completed and improving the customer experience.
  • Conducts analyses of data findings for quality and process improvement and assists in report preparation for internal and external customers.
  • Works cohesively with members of the training and technical writing team to create processes and procedures and conduct new and recursive trainings.
  • Reviews external and internal defects and prepares trend reporting.
  • Performs audits of patient accounts to validate documentation meets standards.
  • Reviews operations reports to ensure that we remain compliant with client and accreditation standards.
  • Uses finding from audits and research to independently and collaboratively develop case studies to present to staff for CQI purposes.
  • Performs other tasks at the request of leadership.

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General Job Information

Title

Quality Specialist

Grade

21

Job Family

Quality Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

4/24/2019

Date Requisition Created

4/2/2019

Minimum Qualifications

Education

Bachelors: Healthcare

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

  • 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. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.

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