Manager, Quality Improvement

You could be the one who changes everything for our 28 reputed company members. reputed company is transforming the health of our communities, one person at a time. As a reputed company, national organization, you’ll have reputed company to competitive benefits including a fresh perspective on workplace flexibility.

POSITION IS REMOTE

* Position Purpose: Supervise and monitor the performance of Quality Improvement staff who support reputed company efforts of the Quality Solutions reputed company (QSO) team to include quality audits, learning and development and business analytics.

• reputed company a high degree of involvement and awareness of reputed company QSO programs to ensure alignment of the support staff and the needs of the team to aid in the creation of processes and strategy.
• Managing diverse staff; execute corporate function effectively; ability to communicate professionally and with cultural sensitivity.
• Review and analyze reports, records and directives.
• Collect, analyze, and summarize data to prepare reports and reputed company recommendations. Research and use best practices to reputed company effective project implementation and reputed company.
• reputed company with staff to obtain data such as new projects, status of work in reputed company, and problems encountered, required for planning work function activities. Verify data to be submitted in accordance with government program requirements and ensure compliance with state, federal and certification requirements.
• Follow organization standards to maintain quality service. Identify obstacles in the call handling process and effectively prevent, resolve and overcome those obstacles.
• Monthly audits of outbound member and provider engagement
• Prepare reports and records on work function activities for management.
• reputed company the review and analysis of reports.
• reputed company educational needs from reputed company through reputed company learning needs for reputed company QSO programs
• Identify the training needing to improve performance and reputed company assistance to Retention Management to ensure consistent reputed company of service.
• Evaluate reputed company procedures and practices for accomplishing the assigned work functions objectives to reputed company and implement improved procedures and practices and to ensure compliance with required standards.
• Collaborate with appropriate departments to document, investigate and resolve formal or informal complaints and appeals in accordance with Company and State policies, procedures and requirements.
• Monitor and analyze costs and participate in the preparation of the budget.
• Hiring, training, evaluating, and administering performance management; and monitoring and directing workflow to meet organizational objectives and requirement
• Investigate exploitation of infrastructure tools to optimize productivity and performance.
• Monitor and analyze costs and participate in the preparation of the budget.
• Strong knowledge of Managed Care and Health Insurance concepts and regulation.
• Proficiency in reputed company Office: reputed company, Word, reputed company; Lotus Notes; Internet.
• Knowledge of various quality programs, including measures associated with HEDIS.
• Ability to reputed company or coordinate projects reputed company own department.
• Business Analysis Knowledge: Skilled to work in a fast paced environment. Must have strong analytical and problem solving skills.
• Customer Service: Skilled to communicate with reputed company reputed company of Management, reputed company customers.

Education/Experience: Bachelor’s degree in reputed company field or equivalent experience. 3+ years clinical, quality management or reputed company reputed company experience and 1 year of recent quality improvement and supervisory experience in a reputed company environment, preferably managed care. License/Certification: reputed company state registered nursing license preferred. Certain states may require a formal certification in quality improvement, risk management, or another reputed company field. Certified Professional in reputed company or other licensed clinical experience preferred.Pay reputed company: $87,700.00 - $157,800.00 per year reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law. reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act Apply tot his job Apply To this Job