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QUALITY MGMT SPEC II in Colorado Springs, CO at Beacon Health Options

Date Posted: 5/16/2019

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Quality Specialist II to join our team at our office in Colorado Springs, CO.  The Quality Specialist II  works under the direction of the Colorado Crisis Services Program Director. The Quality Specialist II is an experienced quality professional and is responsible for the coordination, planning, development, implementation, and monitoring of quality management and improvement processes and activities in for the Crisis Services Program.  The Quality Specialist II is also responsible for the oversight of provider relations activities, including provider training.  The Quality Specialist II will establish working relationships with network providers and oversee provider education, program improvement initiatives, and auditing.  This will include oversight of provider corrective action activities (e.g., performance improvement plans, corrective actions plans, and recoupments) as needed

Position Responsibilities:

  • Working knowledge of relevant NCQA and/or URAC standards as they are required by the client contracts.

  • Build and maintain working relationships with Crisis Services network providers.

  • Develop and oversee provider education and improvement initiatives and work with providers to incentivize process improvement.

  • Initiate and oversee all Provider corrective action activities related to Crisis Services

  • Under the direction of the Colorado Crisis Services Program Director, when needed, conduct audits/internal assessments of clinical and operational service center activities to ensure compliance with corporate policies, quality management activities and accreditation standards.

  • Provide ongoing support for accreditation survey preparation.

  • Assist in preparation and submission of required monthly, quarterly, semi-annual, and annual reporting to ensure timely delivery to internal and external clients.

  • Serve as an internal consultant for Crisis Services performance improvement activities and Provider Relations activities including:

    • Facilitation and coaching with both internal customers as well as external (i.e. network providers).

    • Coordination of QIAs, surveys, research and other supporting functions.

    • Role Model for QM principles and practices.

  • Participates in internal and external Quality Management Committees or Workgroup activities.

  • Works closely with Crisis Services partners to support comprehensive, efficient and integrated systems that ensure communication and positive outcomes.

  • Adheres to all Beacon policies and procedures and standards of operations.

  • Completes all required and assigned trainings.

  • Attends all mandatory company or department meetings.

  • Reports to each scheduled shift and commence work and perform essential job function at the start of each schedule shift.

  • Displays a positive, constructive, and helpful demeanor that is conducive to a safe and respectful work environment.

  • Acts as a mentor to junior team members by leading by example and guiding with a sense of integrity and team work.

  • Assists management with identifying opportunities for staff improvement, high performing team members, and training needs of team members.

  • Assist team members and offers suggestions to improve processes, culture, or work environment.

  • Performs special projects and other duties as assigned and required.

Position Requirements:

Education: BA in QM and or health care related field, MA degree in health care highly preferred

Relevant Work Experience:   Minimum of 5 years work experience in one of the following related fields: QM, Psychology, Behavioral Health, Statistics, or relevant QM or Managed Care Experience.

Knowledge, Skills & Abilities:

  • Microsoft Office products fluency

  • Analytical and problem solving ability

  • Excellent written and verbal communication skills

TO APPLY

Click below on “Apply for this Position” to create a profile and apply for the position

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

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