strong quality program.
- Serves as quality improvement specialist for the quality program with the goal to meet contractual requirements and performance guarantees.
- Duties include evaluating current processes; conducting gap analyses, and recommending/participating in quality improvement activities to address gaps and increase compliance with contractual requirements.
- Leads and performs all aspect of audit processes, including planning, testing, data collection and analysis.
- Prepares objective, factual reports of audit outcomes including best practices, opportunities for improvement, training needs, future risks.
- Develops/revises operational policies and procedures and instructional materials after mitigation/correction activities are determined. Coordinates with any vendors outreach and interventions.
- Prepares status reports on activities and outcomes of interventions and activities.
- Supports monthly, quarterly and annual reporting and trending of performance measures identified on the Quality Control Plan.
- Supports survey administration and collection of responses.
- Provides documentation for quality reports required by the contract.
Other Job Requirements
Responsibilities
3-5 years of experience in quality improvement.Knowledge quality improvement processes.
Attention to detail and able to work efficiently to meet deadlines and timelines.
High degree of organization required.
Excellent verbal and written skills and the ability to enter data accurately into spread sheets and prepare professional looking documents and reports.
Proficient in data management, data analysis, reporting word processing, and project management., preferably with Salesforce and Microsoft office platforms.
Basic statistical skills.
General Job Information
Title
Sr. Quality Specialist, MFLC (Remote)Grade
26Work Experience - Required
QualityWork Experience - Preferred
Education - Required
Bachelor's - HealthcareEducation - Preferred
Master's - HealthcareLicense and Certifications - Required
License and Certifications - Preferred
CPHQ - Certified Professional In Healthcare Quality - Care MgmtCare Mgmt, LSSBB - Lean Six Sigma Black Belt Certification - EnterpriseEnterprise, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtCare MgmtSalary Range
Salary Minimum:
$70,715Salary Maximum:
$113,145This 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.
Skills Required
- 3-5 years of experience in quality improvement
- Experience conducting audits, testing, data collection and gap analyses
- Knowledge of quality improvement processes
- Proficient in data management, data analysis, reporting, word processing, and project management
- Basic statistical skills
- Excellent verbal and written communication skills; accurate data entry into spreadsheets and professional report preparation
- High degree of organization, attention to detail, and ability to meet deadlines
- Experience with Salesforce
- Experience with Microsoft Office (Excel, Word, PowerPoint)
- Bachelor's degree in Healthcare
- Master's degree in Healthcare
- CPHQ (Certified Professional in Healthcare Quality)
- LSSBB (Lean Six Sigma Black Belt)
- Registered Nurse (RN) licensure, state or compact
What We Do
Magellan Health is a leader in managing the fastest growing, most complex areas of health, including special populations, complete pharmacy benefits and other specialty areas of healthcare. Magellan supports innovative ways of accessing better health through technology, while remaining focused on the critical personal relationships that are necessary to achieve a healthy, vibrant life. Magellan's customers include health plans and other managed care organizations, employers, labor unions, various military and governmental agencies and third-party administrators.








