Responsible for assigned areas of behavioral health quality within a specified unit of a Magellan Strategic Business Unit (SBU). Implements assigned quality program components. Interfaces with customers and regulatory entities. May have accreditation responsibilities based on contract requirements. Oversees clinical processes and quality clinical staff as related to clinical audits, completes quality of care reviews, and interprets clinical documentation and application of regulatory or accreditation standards.

　　Manages day-to-day quality activities ensuring program and procedures support company goals for service, quality, and cost effectiveness as well as compliance with contract, federal and state requirement. Supervises proactive clinical quality unit and projects to meet unit goals for quality program as applicable.

　　Supervises quality staff to ensure successful execution of projects and initiatives.

　　Interfaces with customers, regulators or other stakeholders on quality programs, external or regulatory audits.

　　Conducts training sessions on Continuous Quality Improvement (CQI) processes.

　　Coordinates quality initiatives across operational departments, collaborating with leadership across the enterprise. Ensures quality process implementation; root cause analysis, qualitative and quantitative analysis, intervention and measurement development and formal documentation.

　　Coordinates satisfaction survey and follow-up and coordinates Advisory Groups.

　　Tracks adverse incidents and Quality of Care concerns.

　　Monitors performance measures, review trends and makes recommendations for operational improvement.

　　Supports provider profiling.

　　Audits for quality control. Audits include the review of clinical processes against clinical criteria, regulatory requirements, and accreditation standards. Providing results and consultation with customers.

　　Conducts quality studies and manages quality improvement projects.

　　Prepares customer and site reports with assistance from Reporting and Analytics team.

　　Work with the Enterprise Quality organization to identify opportunities. Participation on quality committees to ensure quality issues are taken to the committee and recommendations are made, by the committee, in a timely manner. Makes recommendations to the Committee for improving plan operations based on data from performance indicators, QI studies, and quality activities. Collaborates on the development and implementation of any new initiatives, interventions, or best practices from committee recommendations.

　　Serves as liaison with assigned departments to ensure quality projects are integrated within operations.

　　Supervises Clinical Reviewers and the clinical oversight functions performed.

　　Conducts internal audits of charts and clinical/service procedures for quality purposes.

　　Other Job Requirements

　　Responsibilities

　　5+ years of Behavioral Health quality improvement experience.

　　Licensed Clinical Social Work (LCSW) or Licensed Professional Counselor (LPC) required.

　　Knowledge of quality improvement processes and performance measurement.

　　Demonstrated skills in project management.

　　Strong interpersonal and organizational skills.

　　Expertise in word processing and data management software.

　　General Job Information

　　Title

　　Mgr, Quality, BH

　　Grade

　　28

　　Work Experience - Required

　　Behavioral Health, Quality

　　Work Experience - Preferred

　　Education - Required

　　Master's - Behavioral Health

　　Education - Preferred

　　License and Certifications - Required

　　LCSW - Licensed Clinical Social Worker - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt

　　License and Certifications - Preferred

　　LSSBB - Lean Six Sigma Black Belt Certification - Enterprise, LSSGB - Lean Six Sigma Green Belt Certification - Enterprise

　　Salary Range

　　Salary Minimum:

　　$83,890

　　Salary Maximum:

　　$142,610

　　This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

　　This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

　　Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

　　Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

　　Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

　　Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

　　Warning: Employment Scam

　　It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. “Interviews” are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

　　Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

　　If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911