Quality Specialist II

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $53.1k - $85k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Magellan Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

💼 Consulting

🛡️ Insurance

🏥 Healthcare

💰 $101M Private Equity Round on 2004-01

Consulting • Insurance • Healthcare

Magellan Health is a leading healthcare management company that provides a range of services, including behavioral health, pharmacy management, and employee assistance programs. The company focuses on delivering high-quality care and support to individuals and families, particularly those in military and community settings. Magellan Health emphasizes personalized service and innovative solutions to improve health outcomes and enhance the overall patient experience.

📋 Description

• Serve as a member of the quality team at the national, regional, or unit level • Coordinate projects supporting continuous quality improvement and process improvement • Support maintenance of quality programs, measured processes, and reported outcomes • Coordinate quality and process improvement activities, including accreditation support, quality studies, CQI training, prevention programs, care coordination initiatives, satisfaction survey follow-up, advisory groups, adverse incident tracking, performance guarantees, CAPs, and customer quality initiatives • Conduct quality control reviews and external/internal audits • Summarize findings and prepare reports • Assist with customer audit preparation • Analyze data findings for quality and process improvement and assist with internal and external report preparation • Lead and/or support quality committees and work groups through project management • Ensure accurate and timely documentation, agenda presentation, and follow-up actions • Monitor and execute deliverables to meet customer requirements and performance guarantees • Work independently while maintaining a high degree of organization

🎯 Requirements

• 2+ years of HEDIS-related experience (where applicable) • 2+ years of quality improvement and auditing or related experience in the healthcare field • Attention to detail and ability to work efficiently to meet deadlines and timelines • High degree of organization • Expertise in data management, data analysis, reporting, word processing, and project management • Strong working knowledge of Microsoft Excel, VISIO, and/or MS Project • Knowledge of HEDIS and accreditation requirements, including NCQA and/or URAC (where applicable) • Knowledge of healthcare quality improvement processes, accreditation standards, and HEDIS/performance measurement • Excellent verbal and written skills • Ability to enter data accurately into spreadsheets and prepare professional documents and reports • GED or high school education required • Must comply with applicable legal, regulatory, contractual, and internal policy requirements

🏖️ Benefits

• Short-term incentives may be available • Comprehensive benefits package • Health, life, voluntary, and other benefits • Benefits and perks supporting physical, mental, emotional, and financial wellbeing • Tobacco-free workplace