Manager of Quality& Outcomes Management - Health Plan

 
Position: Manager of Quality& Outcomes Management - Health Plan

Job ID: 154365

Location: US-TX-Bellaire

Department: Quality Management

Talent Area: Registered Nurse

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a-5p

About Texas Children's Hospital

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.   To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.   Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Summary:

We are searching for a Manager of Quality Outcomes Management­– someone who works well in a fast-paced setting. In this position, you will be responsible for training, assessing, and coaching quality nurses. You will be working closely with physicians and other providers and responsible for assisting the Director of Quality and Outcomes Management to plan, organize, develop and manage the Quality Program.

 

Think you’ve got what it takes?



Responsibilities :

  • Demonstrates Quality Improvement management skills as evidenced by utilization of appropriate methodology, analysis and facilitation skills.
  • Responsible for ongoing analysis of claims data to identify needs for quality/performance improvement.
  • Identify trends, patterns and knowledge deficits.
  • With the Director, Quality and Outcomes Management, develops plans for interventions, assures timely implementation, monitors outcomes, and adjusts interventions as needed to assure continuous quality improvement.
  • With the Director, Quality and Outcomes Management, responsible for responses to regulatory audits.
  • Prepares and submits annual capital and operating budgets.
  • Conducts appropriate investigations and follows-up on individual and patient complaints.


Qualifications:

  • Bachelor’s degree in Nursing required
  • License Nurse from the Texas Board of Nursing
  • CPHQ - Certified Professional in Healthcare Quality preferred
  • Seven years’ experience in quality, medical management or compliance experience


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