Director, Quality Management in Rocky Hill, CT at Beacon Health Options

Date Posted: 4/3/2018

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Quality Management Director (Manager, Quality) to join our team at our office in Rocky Hill, CT.  The Quality Management (QM) Director is responsible for the implementation and maintenance of the treatment record review contract requirements as well as the day to day oversight of QM Department activities.  This includes the supervision of QM Department staff with particular attention to assuring that performance standards are being met and follow-up tasks accomplished.  The position assists the Vice President of QM in identifying opportunities for quality improvement, project managing performance targets, assuring follow-up on the investigation of quality of care concerns and complaints, implementation of policies, management of grievances and appeals processes, establishing and monitoring of corrective action plans, coordinating the interdepartmental submission of the annual and semi-annual reports and QM trilogy documents, and coordinating the implementation of enhancements to processes.  The Director works collaboratively with the Director of Provider Analysis and Reporting (PAR) to support the Regional Network Department’s efforts to monitor and evaluate network facilities, program’s and provider’s utilization and quality of care, identify network gaps, and develop strategies both statewide and local to impact network quality.

Position Responsibilities:

  • Takes the lead on the development, implementation and maintenance of the contractually obligated Treatment Record Review process.

  • Supervises and evaluates the performance of all staff assigned to complete auditing, management of complaints/grievances, appeals, quality of care concerns, adverse incidents, and completion of level of care reviews.

  • Oversees the day to day review of incoming Quality of Care concerns and assures that the Quality of Care Committee reviews and follows-through on recommendations of that committee, including the development and monitoring of Performance Improvement Plans as indicated.

  • Collaborates with the Director of PARs and supports the Regional Network team’s efforts to monitor and evaluate network facilities, practitioner’s and provider’s utilization and quality of care, identify network gaps, and develop strategies both statewide and local to impact network quality.

  • Oversees the day-to-day compliance aspects of the QM program including compliance with contracts, State of Connecticut, and federal requirements.

  • Assists with maintaining internal performance and productivity standards, and the timely production of the contractually obligated reports.

  • In collaboration with and in support of other department leadership, plans and participates in the execution of process improvement projects when opportunities for improvement in efficiency and productivity are noted in any CT BHP departments.

  • Plans, coordinates, and monitors the submission of key contractual deliverables including but not limited to the semi-annual and annual utilization reports, the performance standard report card, and the QM Trilogy documents.

Position Requirements:

Education: Post-graduate degree in behavioral health or public health.

Licensure:  Independent Clinical License Required

Relevant Work Experience:   Minimum five (5) years’ of management experience, preferably in a managed care setting.

Knowledge, Skills & Abilities:

  • Leadership skills

  • Clinical supervision skills

  • Public speaking & presentation skills

  • Teaching skills

  • Conflict resolution

  • Writing skills

  • Organizational skills

  • Basic data analysis & performance improvement skills

  • Clinical auditing skills

TO APPLY

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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

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