Quality Management Specialist I in Cypress, CA at Beacon Health Options

Date Posted: 1/25/2020

Job Snapshot

Job Description

We Help People Live their Lives to the Fullest Potential!

For more than 30 years, Beacon has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 40 million people across all 50 states. At Beacon, we are committed to delivering a ‘world-class’ candidate experience from the moment you click ‘Apply’! Our goal is to help you reach your fullest potential, while utilizing your talents and expertise to help us deliver on our promise.

Do you have a passion for helping others? If so, we are looking for you!

Beacon is currently seeking a Quality Management Specialist I a highly organized and compassionate professional to join our team at our Cypress, CA offices.  This position supports and assists in the coordination of all activities managed within the Quality Management department. Assists with the planning, development, implementation, monitoring and analysis of quality and risk management processes and activities.

What does a typical day look like?

  1. Assists in scheduling, preparing agendas, taking minutes and organizing documentation for the Quality Management committee meetings. 
  2. Assists in the receipt, documentation and assigned aspects of an investigation of member adverse incidents or quality of care issues. 
  3. Assists in maintaining member educational materials and clinical resources on the website to ensure that the information contained on the website is current and notifications are provided to network practitioners, providers, and clients in a timely manner.
  4. Assists with data entry and specified analyses of required monthly, quarterly, semi-annual, and annual reporting to ensure that the reports are complete, accurate, and submitted in a timely manner. 
  5. Assists in the preparation of client audits and accreditation. 
  6. Coordinates and/or assists in interdepartmental quality improvement activities. 
  7. Assists in monitoring and evaluating the effectiveness of the performance measures outcomes to determine the effectiveness of the implemented interventions. 
  8. Assists the Quality Manager in the administrative functions and project management of the provider treatment record review process.
  9. Processing re-credentialing monitoring requests.
  10. Processing Quality of Care committee external participant invoices.
  11. Processing requests for designated record set requests and requests for records (e.g., via subpoena, court order, etc.).
  12. Maintains and tracks all Quality department policies and procedures.
  13. Manages member and provider correspondence documents sent from the Quality Department.
  14. Enters demographic member and provider information into the QM database.
  15. Coordinate and distribute National Credentialing Committee referrals.
  16. Cross trains and performs other duties as assigned.

What you Contribute?

Education: Associates Degree with 3 years relevant work experience, Bachelor’s Degree Preferred

Licensure: N/A

Knowledge, Skills & Abilities:

Prefer candidate with behavioral health quality management experience or experience in a managed care environment, experience scheduling committee meetings, maintaining agendas/minutes, policy and procedure maintenance, prioritizing multiple deliverables, maintaining accuracy and confidentiality, knowledge of NCQA/URAC accreditations, solid organizational skills, and strong customer service skills.

What Makes Us Different?

  • Here, it’s not just a job – it’s an opportunity to change lives.
  • Our employees are learners, innovators and original thinkers.
  • Our mission and values guide the way we treat our members, providers and each other.

What We Have to Offer:

  • Healthcare benefits available starting day 1!
  • Health & wellbeing incentives, such as gym membership reimbursement
  • 401K with company match to help reach your future financial goals
  • Generous PTO, because we know life happens outside of work
  • Tuition reimbursement so you can keep reaching your fullest potential

If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started!

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.