Healthcare - Quality Positions - CA

San Diego CA 92108

Job Description

Currently recruiting for various positions in our Quality Department!!

Serves 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.

Essential Functions

- 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.

- Bachelor's degree with 3-5 years healthcare and quality experience.
- Quality techniques and tools, statistics, analytics, research
- Managed care/health plan experience.
- Writing skills -Qualitative and quantitative analysis
- Project Management experience, Process Improvement, development of corrective action
plans and tracking.
- Demonstrated ability to execute; ability to communicate effectively in written and verbal.
- Advanced proficiency with Excel, and other statistical software experience.

MINIMUM EXPERIENCE for Manager level position:
- Master's degree, 5 years healthcare and quality experience
- Leadership and management/supervisory experience.

General Job Information


Healthcare - Quality Positions - CA



Job Family

Quality Group


United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date


Date Requisition Created


Work Experience



Bachelors: Healthcare (Required), Masters: Healthcare (Required)

License and Certifications - Required

License and Certifications - Preferred

LSSBB - Lean Six Sigma Black Belt Certification - Enterprise, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt

Other Job Requirements


-Expertise in data management, data analysis, reporting word processing, and project management skills.

-Knowledge of HEDIS/meaurement specifications, accreditation standards and quality improvement processes. -Attention to detail and able to work efficiently to meet deadlines and timelines. -High degree of organization required. -Excellent verbal and written skills and the ability to enter data accurately into spread sheets and prepare professional looking documents and reports.3-5 years quality improvement/HEDIS related experience


-Licensed behavioral health clinician

-MA in health care or related field.

-Experience in Lean Six Sigma.

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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