RN Job In Little Rock, Arkansas
PASSE Quality DirectorNext Steps... Apply Now
AR: Little Rock
Quality Mgmt / Performance Improvement
The PASSE Quality Director reports directly to the AR VP Clinical Director and is responsible for the day to day quality management and improvement activities within Arkansas PASSE
ABOUT THE POSITION
We are currently seeking a dynamic Quality Director-PASSE to join our team at our office in Little Rock, AR. The PASSE Quality Director reports directly to the AR VP Clinical Director and is responsible for the day to day quality management and improvement activities within Arkansas PASSE. In this role the Quality Director oversees total health of the AR PASSE program, as well as, AR DHS specific quality improvement projects, patient safety activities, and directs & collaborates with behavioral health, physical health and other delegates on quality activities, operational and analytic related activities.
Delivery of exceptional quality operations
- Primary interface with delegates in Quality related committees including Delegation Oversight meetings and audits
- Produce annual AR QM Trilogy Documents, including tracking and updating Strategic Work Plan activity progress and annual Program Evaluation
- Implement corporate policies and create local quality addenda and SOPs when needed
- Produce and oversee production of PASSE and delegation reports required for meeting contractual standards
- Provide Quality thought leadership to clinical, delegates and account leadership.
- In collaboration with the RCQL and corporate quality ensure ongoing compliance with all AR DHC standards.
- Assist with delegation vendor oversite, inclusive of audits and readiness review.
- Train/coach team members on corporate, market, and regulatory developments that impact their roles and functions
- Lead for PASSE Quality Committee structure, Chair AR QMUMCM Committee, may support and co-chair PASSE Committee reporting to EMPOWER Board.
- Report monthly to EMPOWER Committee on PASSE quality, UM and activities as well as metrics and outcomes, of CM and delegates
- Lead on Member Satisfaction survey administration and analysis in collaboration with Corporate Quality
- Conduct specific quality trainings as requested by Corporate Quality for monthly quality training series
- Approximately 20% local travel
Lead quality performance improvement, implementation, and program development
- Implement and coordinate the PASSE Quality Assurance and Performance Improvement (QAPI) program including reports on quality and service metrics.
- Lead Quality Improvement Activities (QIAs) to support AR accreditation and performance improvement including developing, implementing, monitoring and tracking performance of PASSE programs, inclusive of delegates quality programs
- Oversee QIA program development ensuring fidelity to the AR expectations, and potentially CQI model
- Lead EQRO projects in collaboration with delegates
- Collaborate with Delegate/Vendors Managers and the Region to track performance of Core Performance Indicators (CPIs)
- Collaborate with delegate/vendors on specific AR HEDIS measures measurement and improvement opportunities
- May collaborate with Corporate Quality on HEDIS rate production and client deliverables
- Monitor PGs and SLAs relating to quality for PASSE and Vendors, and implement and monitor CAPs in collaboration with internal stakeholders, Delegates/Vendors, and providers
- Implement and monitor CAPs related to Corporate Quality as well as external client delegation and regulatory audits for AR accreditation readiness
- Coordinate with Compliance on program integrity issues
Master's Degree in a related field (healthcare administration, behavioral sciences, business, project management)
Licenses: Current, valid and unrestricted clinical license (e.g., RN, LPC, LCSW, LMFT) preferred
Years and Type of Relevant Work Experience:
Preferably, five years managed healthcare or related experience. A working knowledge of quality management practices and principles, NCQA and/or URAC standards and accreditation process, and HEDIS BH measures is essential. Demonstrated proficiency in CQI tools and techniques. The candidate must have a strong customer service orientation, excellent written and verbal communication skills, and experience using management information systems. Knowledge and experience related to clinical services will be beneficial.
Knowledge, Skills & Abilities:
- Excellent computer skills
- Strong analytical and problem solving skills
- Strong written and verbal communication skills
- Detail oriented and able to work independently
- Supervisory experience
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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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