Share this Job
Director Quality Management - Medicare Job
Amerigroup
Date: May 22, 2013
Location: Virginia Beach, VA, US
Director Quality Management - Medicare
Job ID 2012-19202 # Positions 1
Location US-VA-Virginia Beach
Search Category Quality
Type Regular Full-Time (30+ hours) Posted Date 5/24/2012
Additional Locations ..
More information about this job:
Summary:
The Director Quality Management (Corporate) is responsible for the coordination, direction, planning, implementation and oversight of activities that lead, support and/or monitor organizational quality management for multiple lines of business and products. The position provides broad oversight and direction for collaborative Plan and corporate initiatives, and ensure quality programs meet or exceed guidelines or requirements through strategic planning, policy/procedure development, and execution.
Responsibilities:
1. Support implementation of a comprehensive QM program to meet the demographic and epidemiological needs of the populations served in multiple areas.
2. Promote organization-wide understanding, communication, and coordination of Quality Management.
3. Prioritize areas of business risk and incorporate into the strategy of the Quality management plan.
4. Provide expertise in study design, data collection, aggregation and display of data for all quality activities and initiatives.
5. Coordinate all quality initiatives to appropriate committees on a regular basis as defined through the QM Program description.
6. Research and incorporate best practices and new technology into day-to day operations at multiple locations.
7. Identify quality improvement responsibilities for new markets; develop, coordinate, and implement initiatives within new Plans, and assist with training as needed.
8. Coordinate quality efforts between Plan and Corporate teams to leverage strengths and ensure a collaborative approach to achieving efficiencies and improving outcomes.
9. Assure compliance with State, Federal and CMS quality improvement requirements.
10. Identify, opportunities for performance improvement of government programs through the use of broad performance metrics.
11. Interview, manage, evaluate, and develop new and existing staff.
12. All other duties as assigned.
Qualifications:
EDUCATION AND EXPERIENCE
Education
Required:
- Bachelor’s degree in business or health care related field.
Preferred:
- MSN, MPH, MPA
Years & Type of Experience
Required:
- Seven years in quality improvement in a managed care organization, with three or more years management/leadership experience.
Preferred:
- Previous NCQA accreditation and HEDIS reporting experience.
- Experience with the Medicare and Dual Eligible population preferred.
Certifications or License
Preferred:
- RN or CPHQ preferred.
Language Skills
Required:
- English
Technical Skills
Required:
- Broad knowledge base in quality improvement in managed care environment.
- Excellent written/verbal, presentation and facilitation skills.
- Excellent problem solving and organizational skills.
- Proficiency in organization supported software—word processing and spread sheets.
SCOPE INFORMATION
# Direct Reports: 5 – 10
# Indirect Reports: 15+
Budgetary $ Responsibility:
PHYSICAL REQUIREMENTS
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.
CB1
ermHO
Job ID 2012-19202 # Positions 1
Location US-VA-Virginia Beach
Search Category Quality
Type Regular Full-Time (30+ hours) Posted Date 5/24/2012
Additional Locations ..
More information about this job:
Summary:
The Director Quality Management (Corporate) is responsible for the coordination, direction, planning, implementation and oversight of activities that lead, support and/or monitor organizational quality management for multiple lines of business and products. The position provides broad oversight and direction for collaborative Plan and corporate initiatives, and ensure quality programs meet or exceed guidelines or requirements through strategic planning, policy/procedure development, and execution.
Responsibilities:
1. Support implementation of a comprehensive QM program to meet the demographic and epidemiological needs of the populations served in multiple areas.
2. Promote organization-wide understanding, communication, and coordination of Quality Management.
3. Prioritize areas of business risk and incorporate into the strategy of the Quality management plan.
4. Provide expertise in study design, data collection, aggregation and display of data for all quality activities and initiatives.
5. Coordinate all quality initiatives to appropriate committees on a regular basis as defined through the QM Program description.
6. Research and incorporate best practices and new technology into day-to day operations at multiple locations.
7. Identify quality improvement responsibilities for new markets; develop, coordinate, and implement initiatives within new Plans, and assist with training as needed.
8. Coordinate quality efforts between Plan and Corporate teams to leverage strengths and ensure a collaborative approach to achieving efficiencies and improving outcomes.
9. Assure compliance with State, Federal and CMS quality improvement requirements.
10. Identify, opportunities for performance improvement of government programs through the use of broad performance metrics.
11. Interview, manage, evaluate, and develop new and existing staff.
12. All other duties as assigned.
Qualifications:
EDUCATION AND EXPERIENCE
Education
Required:
- Bachelor’s degree in business or health care related field.
Preferred:
- MSN, MPH, MPA
Years & Type of Experience
Required:
- Seven years in quality improvement in a managed care organization, with three or more years management/leadership experience.
Preferred:
- Previous NCQA accreditation and HEDIS reporting experience.
- Experience with the Medicare and Dual Eligible population preferred.
Certifications or License
Preferred:
- RN or CPHQ preferred.
Language Skills
Required:
- English
Technical Skills
Required:
- Broad knowledge base in quality improvement in managed care environment.
- Excellent written/verbal, presentation and facilitation skills.
- Excellent problem solving and organizational skills.
- Proficiency in organization supported software—word processing and spread sheets.
SCOPE INFORMATION
# Direct Reports: 5 – 10
# Indirect Reports: 15+
Budgetary $ Responsibility:
PHYSICAL REQUIREMENTS
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.
CB1
ermHO
Nearest Major Market: Virginia Beach
Job Segments: Epidemiology, Manager, Quality, Public Health, Medicare, Healthcare, Management