Mgr Quality& Outcomes Mgmt-HP
Mgr Quality& Outcomes Mgmt-HP
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Job Description
Were searching for a Quality & Outcomes Improvement Manger someone whos ready to be part of the best ranked childrens hospital in Texas and among the best in the nation. In this position you will oversee day-to-day operations and manage QI staff. Youll also assist in planning implementing and leading the Quality Improvement Program covering clinical and operational aspects. Ensure compliance with regulatory requirements and accreditation standards.
Think youve got what it takes
Job Duties & Responsibilities
Manages Quality Improvement Specialists and ensures the consistent implementation of quality outreach to network providers.
Assesses the skills and effectiveness of Quality Improvement Specialists in their interactions with providers and implements program changes to enhance their effectiveness.
Takes responsibility for training Texas Childrens Health Plan Quality Specialists to maintain a comprehensive and up-to-date knowledge base for addressing provider and customer issues.
Ensures Quality Specialists promptly and accurately respond to the needs of Credentialing Medical Management Provider Relations Special Investigations Unit and Operations.
Demonstrates Quality Improvement management skills by using appropriate methodology analysis and facilitation techniques.
Conducts ongoing analysis of claims data to identify areas for quality and performance improvement.
Identifies trends patterns and knowledge deficits.
Collaborates with the Director of Quality and Outcomes Management to develop intervention plans ensure timely implementation monitor outcomes and make adjustments as necessary to achieve continuous quality improvement.
Collaborates with the Director of Quality and Outcomes Management in responding to regulatory audits.
Skills & Requirements
Bachelors Degree Required
RN - Lic-registered Nurses Or CPHQ - Cert-cert Prof Healthcare Qual Licenses Preferred
5 Years Of Quality Improvement Medical Management Or Compliance Experience In A Healthcare Setting Required
2 Years Managed Care Organization Or Health Plan Experience Preferred
Required Experience:
Manager
Employment Type
Full-Time
