Director Quality Management

The Director of Quality Management is responsible for the Outcomes Management and Quality Improvement Plan, a program of systematic and objective activities designed to continuously monitor, evaluate, and improve the processes of delivering behavioral health and substance use services, services for intellectual/developmental disabilities, and the quality of clinical care and services provided to children, youth, young adults, and their family/caregivers. The Director is responsible for a formal outcomes assessment process that is standardized, reliable, and valid in accordance with industry standards.

Work Arrangement: Hybrid schedule with 3 days in office in Robbinsville, NJ.

Responsibilities:

• The Quality Improvement program includes the overall management of complaints and grievances; evaluation of the quality of clinical care provided to youth and families; and the organization-wide monitoring, analysis, and improvement of clinical and non-clinical processes.
• This position collaborates with the State to support the Systems Review Process.
• This position is responsible for working with various departments across the organization to provide an integrated approach to quality of care. The Director of Quality Management provides quality leadership in developing new and improved clinical and administrative processes to maximize operational effectiveness and ensure that contract deliverables are met.
• This position takes a leadership role in certification, accreditation, and other internal and external audit processes; critical incident management; outlier and outcomes management; compliance with applicable fraud and abuse state and federal regulations; and coordinating these requirements with the local Compliance Manager.
• This position ensures policies and procedures are reviewed and revised annually or as required by the line of business.
• The Director of Quality Management supervises a team of quality coordinators, manages assignments, and provides feedback on job performances and goals.
  
  

Education:

• Master’s degree in social work, nursing, counseling, or doctorate in psychology required
• Must be licensed in the State of New Jersey to include, Social Work, Psychologist, Registered Nurse
• Preferred certifications to include, National Association for Healthcare Quality (NAHQ), Lean Sigma, ASQ Certification or ISO
  
  

Experience:

• 10 years’ experience in healthcare and in quality assurance and improvement.
• Knowledge and experience of statistics and research to conduct data analysis/evaluation.
• Excellent communication skills: Verbally and in writing with all internal and external customers.
• Strong presentation skills required.
• Ability to handle conflict and difficult situations.
• Strong time management, project management, and organizations skills.
• Ability to use PC’s in a Windows based environment.
• Ability to foster growth and teamwork.
• Strong & demonstrated leadership and management skills resulting in the ability to make decisions independently and manage personnel.
  
  

The range displayed in this job posting reflects the minimum and maximum for new hire salaries for the position in the Robbinsville, NJ area.

Within the range, individual pay is determined by additional factors, including, without limitation, job-related skills, experience, and relevant education, certifications, or training. AmeriHealth Caritas associates are eligible to participate in our annual incentive program and will also receive our benefits package, consisting of medical, vision, dental, life insurance, disability insurance, 401(k), paid time off and more.

The targeted hiring range for this role is expected to be between $123,100 and $203,800.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.