Manager Quality Management

Under the direction of the Director, Quality Management, the Manager of Quality Management is responsible for providing oversight, direct supervision and day-to-day management of the Quality Management Team. This position oversees integration of quality monitoring and interventions for improving HEDIS rates and provides process assistance to business owners for performance improvement projects. The incumbent provides direction and support to the Quality Management team and assists the Director in ensuring Plan compliance with state regulations and accreditation standards.

+ Directs the Quality Operations Program, following the National Committee for Quality Assurance (NCQA) Standards and Guidelines Quality Management, as well as, the contract with the State and requirements of regulatory bodies
+ Maintains current knowledge of Health Plan Policy and Procedures, State Requirements, NCQA Standards and HEDIS specifications.
+ Participates in the planning, developing, and im...