Quality Management Specialist
$58,300–$58,300 year
On-sitePhiladelphia, Pennsylvania, United States
Job Summary
Track and trend reported quality issues, producing trend analysis and investigating clinical concerns to complete required documentation. Facilitate provider teaming meetings, conduct on-site visits, monitor Quality Improvement Plan submissions, and prepare letters to providers. Assist with coding Significant Incident Reports and determining necessary follow-up actions. Requires a Master's degree in behavioral health or social sciences, three years of post-graduate experience including two in healthcare or quality management, proficiency in Microsoft Office, and knowledge of PA Act 68. Candidates must be current Philadelphia residents or become residents within six months of hire and possess U.S. work authorization without sponsorship.
Required Qualifications
- Master's degree in behavioral health, healthcare or social sciences
- Minimum of 3 years of post-graduate experience with at least 2 years of experience in a health care or quality management setting
- Proficient in Microsoft Office applications
- Excellent written and verbal communication skills
- Must have knowledge of PA Act 68, Appendix H and medical necessity criteria
- Customer service skills
- Training and facilitating skills
- Strong interpersonal skills
- Thorough knowledge of DBH and DHS systems and services
- Must be a current Philadelphia resident or become a resident within six months of hire
- Must be legally authorized to work in the United States without requiring sponsorship now or in the future
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