Location: Must live within 50 miles of our Seven Fields, PA PulsePoint office.
Responsible for serving as a liaison with and overseeing the quality improvement activities/projects/programs for one or more states within a major line of business.
How you will make an impact:
Leads state level quality strategy meetings, develops a quality plan, and ensures integration of quality into the overall business process.
Works with the clinical intervention team to design studies to identify barriers to medical interventions.
Assisting with and conducting medical record reviews for Behavioral Health providers
Train and mentor staff who conduct audits
Ensures that study methodology is sound and appropriate reporting is in place.
Develops performance improvement plans and oversees the clinical quality improvement activities/projects to improve the quality of care for members.
Assures compliance with corporate QI work plans.
Assures that all QI activities are relevant to the needs of targeted population.
Maintains effective documentation of research programs to meet regulatory and Accreditation Standards.
Oversees the implementation of new initiatives.
Leads interactions with regulators or oversight entities.
Oversees quality improvement activities for the largest, most complex state programs.
Minimum Requirements:
Requires a BS in health administration, nursing, or a related clinical field; 4 years of health care quality or data analysis experience; or any combination of education and experience, which would provide an equivalent background.
Current unrestricted license, certification in applicable field (i.e. CPHQ) and/or a MS in the health field (i.e. Nursing) is preferred.
Preferred Qualifications:
Strong knowledge of ASAM
Substance use disorder experience
Current unrestricted license in behavioral health field (LSW, LCSW, LPC, etc)
