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Quality Manager, Managed Care, NCQA

Company: RCM Healthcare Services

Location: New York, NY

Contact Information


Name: Lindsay Roseman
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Job Description

Large chronic illness and behavior health case management organization is looking for a Quality Manager for their Midtown Manhattan Office.

Ideal Candidate will have worked with or obtained NCQA Accrediation for a Managed Care Organization

 

The Quality Manager reports to the Service Center Director of Quality Management (QM), but also works extensively with the Director of Clinical Operations (UM).  Supports Service Center QM and UM program description and work plan initiatives.  Manages projects, programs and large-scale meetings.  This position requires interface with practitioners and consumers to address quality inquiries.  Manages team of quality analysts.

 

Salary up to $80,000(flexible +)

 


Job Requirements

 

  • Bachelor's degree required, Master's degree preferred, in healthcare field, management or public administration. 
  • Licensure in a mental health related field (Ph.D., RN, LCSW/ACSW, etc.) referred. 
  • Certification in health care quality program preferred.
  • Minimum of three years of quality assurance/management experience in a clinical or managed care setting. 
  • Ability to work independently in an interdisciplinary setting and coordinate quality management/utilization management initiatives with various departments. 
  • Excellent verbal and written communication skills, strong analytical and organizational abilities, and two years experience coordinating accreditation criteria and process (NCQA and/or URAC) required. 
  • Knowledge in the concepts, principles and practical applications of quality management initiatives (i.e., indicator development, benchmarking and outcomes). 
  • Knowledge and expertise in the area of utilization management, preferably in a managed care setting, required. 
  • Project management experience required. 
  • Familiarization with HIPAA and risk management practices preferred.


Salary up to $80,000(flexible +)

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