Quality Manager, Behavioral Health, Remote in the state of CA

KePRO

Nashville Tennessee

United States

Social Services / Counseling
(No Timezone Provided)

Description

Quality Manager

  • Are you an experienced healthcare professional looking for a new challenge?
  • Are you motivated, energetic, and excited to become part of the Kepro team?
If so, you might be our next new team member!

Note: This is a remote position but you must live in the state of California per contract requirements.

Candidates – please take note. Kepro holds significant contracts with the federal government. As of December 8, 2021, Kepro will require its employees to be fully vaccinated against COVID-19 as required by Executive Order 14042. New hires must be fully vaccinated as of their start date and provide proof of vaccination during the onboarding process. Medical and religious accommodations are available to those who qualify.

Who We Need

The Quality Manager oversees day-to-day operations of the Quality Management Program, including the design, development, and oversight of quality monitoring activities. The Quality Manager maintains current information on clinical practice guidelines, health tech assessments, research studies, policies, and recommendations for expert medical testimony; maintains a policy library; develops, coordinates, and implements testing and quality assurance measures and activities; monitors testing and quality assurance policies, processes and procedures; and prepares and submits reports and deliverables on time as required. Supports overall consistency, thoroughness, and accuracy of the Psychiatric Inpatient Concurent Review process with the California Mental Health Services Authority (CalMHSA).

Why us?

Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting.

People Focused. Mission Driven.

Shape the future of healthcare with us. We are mission driven to improve lives through healthcare quality and clinical expertise.

We do this through our people.

At Kepro, you can do meaningful work that makes a real difference for the lives of individuals across the country. We are an organization that cares deeply about our employees and we provide the training and support to do the best work of your career.

Benefits are a key component of your rewards package at Kepro. These benefits are designed to provide you and your family additional protection, security, and support for both your career and your life away from work. They are comprehensive and fit a variety of needs and situations. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more.

What You’ll Do
  • Plans, coordinates, and directs quality assurance program designed to ensure continuous quality of products consistent with established standards and customer requirements.
  • Oversees and facilitates all QA activities, provides continuous improvement consulting services to internal customers, employs knowledge of performance improvement strategies, principles, methodology, techniques, and data analysis.
  • Ensures accurate clinical reviews and determinations through accurate assessment of the patient, relevant records, and collateral sources of individuals.
  • Establishes key performance indicators and maintains systems for tracking, reporting and improving performance.
  • Reviews audit results and identify the severity of findings or the risk associated with the findings to ensure the appropriate level of action is taken to eliminate non-conformance.
  • Tracks or follows up on corrective action plans to ensure completion of all items in the specified time frame.
  • Review and evaluate reported crisis (i.e., highly urgent service-related problem with immediate negative implications for the Company) and formulate a plan of action for handling the incident/issues based on area of expertise/responsibility.
  • Attends and actively participates in staff meetings and conducts case consultations/peer reviews/internal auditing.
  • Performs ongoing reassessment of review process to offer opportunities for improvement and/or change.
  • Facilitates and supports Stakeholder Advisory Councils.
  • Utilizes measurable indicators and outcome measurements to determine whether the desired organizational results are achieved.
What You’ll Need

Required Qualifications
  • Bachelor’s Degree in related health care discipline is required.
  • Formal training or certification in quality preferred (CPHQ, ISO, Six Sigma).
Experience
  • Minimum of 2 years of Quality Management experience in a health-related field.
  • Quality management and/or compliance experience required.
  • Experience identifying organizational needs and recommending the appropriate improvements to increase organizational effectiveness.
Knowledge, Skills, Abilities
  • Knowledge of Parity in Mental Health and Substance Use Disorder Services Final Rule (Parity Rule; Title 42 of the CFR, part 438.910)
  • Knowledge of Medicaid programs with relevant experience navigating similar complex projects.
  • Knowledge of psychiatric disorders as defined by the most current Diagnostic and Statistical Manual in use in California.
  • Knowledge of standards of practice related to determination of Level of Care.
  • Knowledge of standards of practice related to mental health and other disorders typically requiring psychiatric inpatient.
  • Knowledge and understanding of public sector services and supports.
  • Computer proficiency in Microsoft Excel, Word, PowerPoint, Teams, and Outlook.
  • Ability to determine a clinical diagnosis accounting for psychological and behavioral issues.
  • Ability to utilize computer equipment and web based software to conduct work.
  • Ability to interact with various office staff as needed to support necessary workflows.
  • Ability to interact with healthcare professionals, patients, their families and other supports.
  • Ability to communicate effectively to individuals and groups through spoken, written and electronic media.
  • Ability to attend to detail, effectively prioritize and execute tasks in a timely manner.
Thank You!

We know your time is valuable and we thank you in advance for applying for this position. Due to the high volume of applicants we receive, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Kepro and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Kepro Talent Acquisition Team

Mental And Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.

Kepro offers challenging careers, excellent benefits and opportunities for advancement. For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please. Visit our website at www.Kepro.com for more information on the Kepro Family of Companies.

EOE AA M/F/Vet/Disability

Kepro is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Quality Manager, Behavioral Health, Remote in the state of CA

KePRO

Nashville Tennessee

United States

Social Services / Counseling

(No Timezone Provided)

Description

Quality Manager

  • Are you an experienced healthcare professional looking for a new challenge?
  • Are you motivated, energetic, and excited to become part of the Kepro team?
If so, you might be our next new team member!

Note: This is a remote position but you must live in the state of California per contract requirements.

Candidates – please take note. Kepro holds significant contracts with the federal government. As of December 8, 2021, Kepro will require its employees to be fully vaccinated against COVID-19 as required by Executive Order 14042. New hires must be fully vaccinated as of their start date and provide proof of vaccination during the onboarding process. Medical and religious accommodations are available to those who qualify.

Who We Need

The Quality Manager oversees day-to-day operations of the Quality Management Program, including the design, development, and oversight of quality monitoring activities. The Quality Manager maintains current information on clinical practice guidelines, health tech assessments, research studies, policies, and recommendations for expert medical testimony; maintains a policy library; develops, coordinates, and implements testing and quality assurance measures and activities; monitors testing and quality assurance policies, processes and procedures; and prepares and submits reports and deliverables on time as required. Supports overall consistency, thoroughness, and accuracy of the Psychiatric Inpatient Concurent Review process with the California Mental Health Services Authority (CalMHSA).

Why us?

Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting.

People Focused. Mission Driven.

Shape the future of healthcare with us. We are mission driven to improve lives through healthcare quality and clinical expertise.

We do this through our people.

At Kepro, you can do meaningful work that makes a real difference for the lives of individuals across the country. We are an organization that cares deeply about our employees and we provide the training and support to do the best work of your career.

Benefits are a key component of your rewards package at Kepro. These benefits are designed to provide you and your family additional protection, security, and support for both your career and your life away from work. They are comprehensive and fit a variety of needs and situations. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more.

What You’ll Do
  • Plans, coordinates, and directs quality assurance program designed to ensure continuous quality of products consistent with established standards and customer requirements.
  • Oversees and facilitates all QA activities, provides continuous improvement consulting services to internal customers, employs knowledge of performance improvement strategies, principles, methodology, techniques, and data analysis.
  • Ensures accurate clinical reviews and determinations through accurate assessment of the patient, relevant records, and collateral sources of individuals.
  • Establishes key performance indicators and maintains systems for tracking, reporting and improving performance.
  • Reviews audit results and identify the severity of findings or the risk associated with the findings to ensure the appropriate level of action is taken to eliminate non-conformance.
  • Tracks or follows up on corrective action plans to ensure completion of all items in the specified time frame.
  • Review and evaluate reported crisis (i.e., highly urgent service-related problem with immediate negative implications for the Company) and formulate a plan of action for handling the incident/issues based on area of expertise/responsibility.
  • Attends and actively participates in staff meetings and conducts case consultations/peer reviews/internal auditing.
  • Performs ongoing reassessment of review process to offer opportunities for improvement and/or change.
  • Facilitates and supports Stakeholder Advisory Councils.
  • Utilizes measurable indicators and outcome measurements to determine whether the desired organizational results are achieved.
What You’ll Need

Required Qualifications
  • Bachelor’s Degree in related health care discipline is required.
  • Formal training or certification in quality preferred (CPHQ, ISO, Six Sigma).
Experience
  • Minimum of 2 years of Quality Management experience in a health-related field.
  • Quality management and/or compliance experience required.
  • Experience identifying organizational needs and recommending the appropriate improvements to increase organizational effectiveness.
Knowledge, Skills, Abilities
  • Knowledge of Parity in Mental Health and Substance Use Disorder Services Final Rule (Parity Rule; Title 42 of the CFR, part 438.910)
  • Knowledge of Medicaid programs with relevant experience navigating similar complex projects.
  • Knowledge of psychiatric disorders as defined by the most current Diagnostic and Statistical Manual in use in California.
  • Knowledge of standards of practice related to determination of Level of Care.
  • Knowledge of standards of practice related to mental health and other disorders typically requiring psychiatric inpatient.
  • Knowledge and understanding of public sector services and supports.
  • Computer proficiency in Microsoft Excel, Word, PowerPoint, Teams, and Outlook.
  • Ability to determine a clinical diagnosis accounting for psychological and behavioral issues.
  • Ability to utilize computer equipment and web based software to conduct work.
  • Ability to interact with various office staff as needed to support necessary workflows.
  • Ability to interact with healthcare professionals, patients, their families and other supports.
  • Ability to communicate effectively to individuals and groups through spoken, written and electronic media.
  • Ability to attend to detail, effectively prioritize and execute tasks in a timely manner.
Thank You!

We know your time is valuable and we thank you in advance for applying for this position. Due to the high volume of applicants we receive, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Kepro and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Kepro Talent Acquisition Team

Mental And Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.

Kepro offers challenging careers, excellent benefits and opportunities for advancement. For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please. Visit our website at www.Kepro.com for more information on the Kepro Family of Companies.

EOE AA M/F/Vet/Disability

Kepro is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Apply