FreshRemote.Work

Quality Control Manager

United States - Remote

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. 

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the company's mission, actively engage in problem-solving, and take ownership of your work every day. Acentra Health offers unparalleled opportunities. You have all you need to take charge of your career and accelerate better outcomes, making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. 

Acentra is looking for a Quality Control Manager  to join our growing team.

Job Summary:

The Quality Control Managerworks closely under the Executive Director, Quality Management and is responsible for the implementation of organizational continuous quality improvement (CQI) model and infrastructure. This is achieved through auditing, and quality metrics reporting. Including the design, development, and maintenance of systems for tracking corporate clinical quality metrics, reporting, and auditing for improvement of performance and compliance with approved processes. These activities support the foundation of the corporate quality management program and systems.

Job Responsibilities:

  •  Implements the Company’s continuous quality improvement (CQI) model “Check” phase.
  • Ensures the implementation of key performance indicators and develops and maintains systems for tracking, reporting, and improving performance. Monitors all quality improvement activities, provides continuous improvement consulting services to internal customers, employs knowledge of performance improvement strategies, principles, methodology, techniques, and data analysis.
  • Promotes awareness of requirements throughout clinical operations. Provides support, including development of QI training, tools, audit templates, and consultation for all corporate business owners and local level quality related functions, identifying opportunities for quality documentation/ evidence compliance via review of submitted documents, and crosswalk to applicable standards utilizing operational knowledge.
  • Provide support and consultation for all corporate business owners and local level quality related functions, identifying opportunities for quality documentation/ evidence compliance
    via review of submitted documents, and crosswalk to standards utilizing operational knowledge
  • Maintains the Clinical Quality Metrics reporting systems and dashboards.
  • Presents the Clinical Quality Metric reports to executive leadership at Corporate Quality committees to meet all accreditation requirements for reporting measures.
  • Manages and allocates staff to conduct and perform analysis of audit results, identifies the severity of audit findings or the risk associated with the findings.
  • Manages quality improvement project process and defines scope of the service capability.
  • Review and update as needed, policy, procedure, program descriptions, and report and template edits.
  • Support the appraisal and survey processes of the Business Quality Management division such as CMMI, ISO, CMS, and URAC.

Requirements

Required Qualifications/Experience:

  • Bachelor’s degree or 5 years of organizational experience required
  •  Minimum 5 Years management level experience (Supervisor or Manager level and above)
  • Minimum 5 years working with/implementation of organizational infrastructure and quality improvement processes and control of business operations.
  • In-depth knowledge of CQI tools, methods, and techniques such as Six Sigma.
  • Excellent grasp and understanding of SPC (Statistical Process Control).
  • Some domestic travel may be required; short and extended possible.
  • Proficient in Microsoft Office programs.   

Preferred Qualifications/Experience:

  • Experience with client payor (Medicare/Medicaid/Commercial/Managed Care) regulations and/or claims processing.
  • Project Management or Quality Certification (Must obtain within 1 year of hire date)
  • Advanced knowledge of HIPAA and state health/privacy regulations.
  • Knowledge of URAC, NCQA, CMMI, or ISO background a plus.
  • Knowledge of healthcare industry; preferably with experience in both public and private sector

Benefits

Why us? 

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as a vital partner to ensure better healthcare and improve health outcomes. 

We do this through our people. 

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career. 

Benefits

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

Compensation 

The pay range for this position is $85,536.00/yr - $118,800/yr

“Based on our compensation program, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.” 

Thank You!

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

·        ~ The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

EOE AA M/F/Vet/Disability

Acentra Health 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, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

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Job Profile

Regions

North America

Countries

United States

Restrictions

Some domestic travel may be required

Benefits/Perks

Career advancement opportunities Comprehensive health plans Corporate Discounts Corporate wellness Educational Assistance Equal opportunity employer Health plans Health solutions Meaningful work Paid Time Off Protection Remote work flexibility Retirement Retirement savings Security Support Supportive team environment Unparalleled opportunities

Tasks
  • Design
  • Develop and maintain quality metrics systems
  • Documentation
  • Implement continuous quality improvement model
  • Manage quality improvement projects
  • Present quality reports to leadership
  • Project management
  • Provide consulting for quality documentation compliance
  • Reporting
  • Training
Skills

Auditing Business Claims processing Clinical expertise Clinical operations CMMI Compliance Consultation Consulting Continuous Improvement Continuous Quality Improvement Data analysis Documentation Healthcare Healthcare industry HIPAA Implementation Leadership Medicaid Medicare Microsoft Office Organizational Performance Improvement Problem-solving Project Project Management Public Sector Quality improvement Quality Management Quality metrics reporting Reporting Six Sigma Statistical Process Control Talent Acquisition Training

Experience

5 years

Education

Bachelor's degree Business DO Healthcare

Certifications

HIPAA

Timezones

America/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9