• Manager, Quality Administration

    Job ID
    2019-90252
    Employment Type
    Full Time
    Department
    Quality Management
    Hours / Pay Period
    80
    Facility
    Dignity Health Management Services Organization
    Shift
    Day
    Location
    Bakersfield
    State/Province
    CA
    Standard Hours
    Monday-Friday 8:00 am- 5:00 pm
    Work Schedule
    8 Hour
  • Overview

    Overview

    The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

    What We Offer

     

    Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

     

    • This position will report to the: Director, Quality Management
    • Percentage Travel Required/Frequency: 40%
    • FLSA Status: Exempt
    • Remote Worker: Non-eligible

     

    Responsibilities

     

    JOB KNOWLEDGE, SKILLS & ABILITIES

    1. Knowledge of CMS DMHC, CA Department of Health & Safety, CA Department of Insurance, NCQA standards, including HEDIS criteria.
    2. Knowledge and experience applying current practices and application of health services as they relate to a Knox-Keene licensed health plan.
    3. Able to effectively provide feedback to team members through written and verbal communication
    4. Strong problem-solving abilities. Ability to identify issues and problems within administrative processes activities, and other relevant areas.
    5. Must be attentive to detail, accurate, thorough, and persistent in following through to completion of all activities, demonstrating initiative for completing work assignments.
    6. Excellent communication skills; able to read, write, and speak articulately, using established channels of communication and reporting relationships within the organization. Ability to communicate effectively with all levels of internal/external staff, management, members, physicians/physician office staff, vendors, etc.
    7. Effectively manage financial resources within the area(s) of responsibility including labor management, productivity, supplies, and other resources.
    8. Ensures optimal provision of services through sound personnel management.
    9. Demonstrates leadership skills including the ability to plan, prioritize, organize, analyze, execute on multiple tasks and in collaboration with other hospital departments, providing direction and setting expectations consistent with the goals of the organization.
    10. Demonstrates behaviors commensurate with the Vision, Mission and Values and Behavioral Standards of the organization.
    11. Ability to read and comprehend documents of a moderately complicated nature including contracts.
    12. Ability to continually re-prioritize to meet the needs of internal and external customers throughout the workday.
    13. Ability to handle various situations in a professional manner, demonstrating excellent customer service at all times and ability to adapt to change.
    14. Possesses strong leadership skills including the willingness to pursue roles with increasing levels of accountability, coaching, teaching, inspiring, forging alliances, and collaborating to negotiate resolution to issues.
    15. Willingness to work as part of a team, working collaboratively with others to achieve goals, solve problems, and meet established organizational objectives.
    16. Strong organizational skills with ability to prioritize multiple priorities and work independently
    17. Proficient in the use of Microsoft Office applications; Excel, Word, Access, Outlook, PowerPoint, Project.
    18. Thorough knowledge of generally accepted professional office procedures and processes.
    19. Ability to use the following general office equipment correctly and safely: desktop computer for data entry and typing, copy machine, scanner and facsimile machine, and of telephone equipment
    20. Ability to create professional documents using proper grammar, punctuation and appropriate reading level.
    21. Must be able to travel to locations both in and out of town which may require overnight stays on occasion.
    22. Ability to be reliable in attendance and timeliness to work schedules.
    23. Ability to adhere to dress code, good grooming, and personal hygiene habits.
    24. Ability to maintain knowledge of and conform to company policies and procedures.

     

    ESSENTIAL DUTIES AND RESPONSIBILITIES

    1. Responsible for meeting all of the MCS Job Standards described below.
    2. Develops and implements the organization’s quality improvement plan in accordance with the mission and strategic goals of the organization, federal and state laws and regulations, and accreditation standards
    3. Develops and implements systems, policies, and procedures for the identification, collection, and analysis of performance measurement data
    4. Collects and summarizes performance data, identifies opportunities for improvement, and presents findings as needed
    5. Updates and maintains risk reporting and risk management system including sentinel and critical event reporting and follow-up.
    6. Responsible for determining proactive methodologies to continue a culture of patient safety and risk reduction within the organization
    7. Reports to administration, medical staff and board on important medical/legal issues.
    8. Actively participates on, or facilitates committees such as: Quality Improvement, Utilization Management, Patient Safety, and Risk Management
    9. Performs other duties as assigned.

     

    Qualifications

     

    EDUCATION & EXPERIENCE

     

    Required

    1. Three or more years of management experience with a focus on quality improvement leadership 
    2. Five or more years working in a managed care or other related healthcare business environment.
    3. Previous experience with Joint Commission Standards and Regulatory Compliance of Other Agencies
    4. Knowledge of JCAHO, URAC, AAAHC and NCQA standards
    5. Must have valid California drivers' license and clean DMV record

    Preferred

    1. Experience in Risk Management and Health Care Compliance Principles 
    2. Bachelors Degree in Healthcare Management or Business Adminstration
    3. Experience working in an integrated healthcare model with process development and program implementation desirable.
    4. Experience managing complex work processes including HEDIS, 5-star and HCC related projects 
    5. Certified Professional in Healthcare Quality 
    6. Certified Professional in Healthcare Risk Management 

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