Director of Quality, Northeast (Health Plan Liaison), Woburn, Massachusetts

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Created 01/12/2019
Reference 11332712
Country United States
State Massachusetts
City Woburn
Zip 01801
Location
MA: Woburn
Job Family
Quality Mgmt / Performance Improvement

Job Brief

We are currently seeking a dynamic Director Quality, Northeast - Health Plan Liaison to join our team at our office in Woburn, MA.

ABOUT THE ROLE:

We are currently seeking a dynamic Director Quality, Northeast - Health Plan Liaison to join our team at our office in Woburn, MA.

This position reports to the Assistant Vice President of Quality and will serve as a leader who develops and implements quality activities and processes for the region and specifically related to health plans clients. This individual oversees the quality and timeliness of health plan reporting for six clients, the record review program, efficient regional functioning adhering to Beacon's policies and standard operating procedures, and data-driven quality improvement activities. This individual will successfully collaborate with other regional team members (such as Provider Quality, Operations, etc.) and shared service team members (such as Network, Credentialing, etc.).

Position Responsibilities:

Primary Liaison for Six (6) Health Plan Clients
  • Maintain a dashboard of all deliverables and reports
  • Ensure quality assurance and timely delivery of reports (approximately 130)
  • Lead monthly meetings with clients to ensure expectations and contract deliverables are met and to add value as a behavioral health quality expert.
  • Coordinate with other departments towards quality improvement activities, as appropriate.
  • Serve as the content expert of quality components in the client contracts.

Oversee the Health Plan Data Analysis and Development of Joint Quality Improvement Activities
  • Ensure the development and analysis of data for the Health Plans to include but not be limited to HEDIS improvement
  • Ensure identification of quality improvement areas and coordinating with the appropriate internal and external departments
  • Participate in and support team members participation in quality workgroups to develop and implement quality improvement activities

Oversee the Northeast Region Record Review Program (approximately 3000 reviews annually)
  • Develop and maintain the dashboard of progress towards annual goals, including tracking project milestones/ work plan objectives.
  • Ensure adherence to the standard operating procedures and update as needed.

Lead Efficient and Exceptional Quality Operations
  • Support the production of QM trilogy documents, including tracking and updating the Health Plan Regional workplan.
  • Implement corporate policies and create/maintain local quality addenda and Standard Operating Procedures, when appropriate.
  • Partner with Corporate Quality and Accreditation towards reporting requests, projects, and departmental goals.
  • Support other Beacon departments towards continuous quality improvement

Employee/Team Management & Development
  • Develop talent via supervision and coaching
  • Delegate and assign projects/reports
  • Provide training and clear expectations
  • Oversee the Manager of Quality, Manager of Quality Analytics, Data Analyst/Project Managers and the Coordinator Team Members

Position Requirements:

Education: Master's degree in Public Health or Behavioral Health required

Licensures: N/A

Years and Type of Relevant Work Experience: 3-5 years of progressive experience in managed care preferred . Leadership skills and supervisory experience, including the ability to develop team performance, preferred

Knowledge/Skills/Abilities:
  • Organizational & Planning: Self-motivated, able to prioritize multiple issues, solid organizational skills, ability to track projects/tasks and follow through as needed
  • Teamwork: Able to work collaboratively with internal staff and external providers/clients
    Follow through on Commitments: Able to manage time-sensitive projects and meet deadlines
  • Strategic thinking/visionary: Able to assess, view and create valuable input
  • Ability to develop people: Able to develop talent by coaching and supporting
  • Communication: Strong written and oral communication skills
  • Proactive: Self-motivated, able to identify opportunities for improvements and implement creative, innovative solutions

TO APPLY

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

Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled

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PM16

AAP Reporting Location:

MA - Woburn

ID (Req #):

56658

FTE Status:

Full Time

Schedule:

8am - 5pm

Exempt

PI106657685
Employer Beacon Health Options

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