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Join a team where your community is our first priority. At Community Care Behavioral Health (CCBH), we're committed to giving your neighbors the quality of life that they deserve. A proud part of the UPMC Insurance Services Division, we provide members with the behavioral health treatment they need for better health and a higher quality of life, including treatment for mental health conditions, drug or alcohol addiction, and developmental disabilities.

Community Care Behavioral Health partners with MetroPlus Health Plan to provide care to its members in the New York City area. With opportunities ranging from clinical to customer service, and everything in between, we're looking for highly motivated and compassionate individuals to join our diverse team where passion is nurtured and rewarded.

We are hiring a full-time Quality Manager to support the Quality Department within the Community Care Behavioral Health Organization (Community Care) / MetroPlus business unit. This will be a Monday through Friday daylight schedule. Moderate travel throughout the NYC metro area is required. The Quality Manager will be based out of the New York City office location.

The Quality Manager oversees performance monitoring, including tracking progress toward meeting performance and outcome standards. The Quality Manager is responsible for managing and performing functions related to quality management and improvement, in compliance with the State of New York Department of Health quality assurance regulations, project reporting and quality improvement deliverables and Community Care needs. The Quality Manager facilitates Significant Member Incident (SMI) and Member complaint investigations and leads local quality-related Committees and other meetings as required. The Quality Manager also provides assistance with identifying relevant questions which are pertinent to program development as well as outcomes of the project; input as to the design of quality reports, analysis and synthesis of quality reports; and tracking, trending, and other information exchanged with contractors as required. The Quality Manager collaborates as needed with other departments to review performance data and identify areas for improvement and associated action plans.

Responsibilities:
  • Responsible for coordinating and managing monthly Quality Committee meetings in collaboration with DOH/OMH
  • Responsiveness to deadlines and has work completed on or before deadline 95% of the time.
  • Ability to analyze empirical administrative data and report findings in user friendly summaries.
  • Responsible for identifying trends related to providers in care delivery and subsequent application of the CQI process
  • Assists with identification of quality and outcomes indicators
  • Monitors development of new/revised data reports and provides feedback regarding content and layout to ensure reports are user-friendly and meet the needs of DOH/OMH. Responsible for preparing monthly and quarterly quality improvement reports in conjunction with Decision Support and Outcomes
  • Responsible for discussion, monitoring, and reporting Significant Member Incidents (SMIs) and adverse Member Events to DOH/OMH
  • Responsible for assisting DOH/OMH in the design and delivery of targeted audits, when requested
  • Identifies opportunities to present at local and major behavioral health and health care conferences
  • Knowledge and Ability to supervise and direct the work of others.
  • Responsible for coordinating quality-related information necessary for City and State review
  • Ability to propose and implement creative solutions to identified trends or problem areas with recommendations for improvement.
  • Responsible for assisting in updating the QI Plan and supporting completion of the current year's work plan
  • Responsible for monitoring care management clinical documentation and telephonic interchange
  • Participates in formulation of questions to be addressed by data analyst and report development staff
  • Excellent clinical, written and oral communication skills.
  • Ability to synthesize complex data from multiple sources to identify trends or problem areas.
  • Responsible for quality data collection, regarding services provided, population(s) served, and provider activity in collaboration with stakeholders, customers, and local and corporate leadership
  • Assists with training responsibilities for providers, consumers (when indicated), and staff on issues related to quality management
  • Ability to oversee the synthesis of complex data to monitor the project's performance with respect to contract deliverables.
  • Independent problem solving based on sophisticated knowledge of quality standards, clinically pertinent issues related to product and population served, and the operating practices of the organization.

Qualifications
  • Minimum 5 years clinical or health related experience, 2 years in a management capacity preferred.
  • Analytic and statistical skills necessary for the design, production, and synthesis of performance monitoring data for the care monitoring initiative.
  • Experience in services research or empirically driven quality management
  • Experience in conducting analyses with secondary data
  • Master's degree in health related field required.
  • PhD or PhD Candidate preferred.
  • This is an outstanding job opportunity for a clinician researcher.
  • Behavioral health experience preferred
  • Strong history of quality management implementation and participation.
  • Ability to implement quality assurance policies and to enforce those policies through appropriate action
  • Ability to maintain effective professional liaison with all levels of executive and medical staff, including professional and institutional providers of care.
  • Ability to design and conduct audits to determine whether the program is being implemented as planned and to synthesize the findings of such audits in user-friendly reports.
  • Strong communication and interpersonal skills

Licensure, Certifications, and Clearances:

  • New York licensure: LMSW, LCSW, LMHC, LMFT, licensed RN (with BSN) and/or a licensed PhD (psychologist) preferred.
  • Justice Center Clearances
UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $34.96 to $59.20 / hour

Union Position: No


* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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