Supervises day-to-day operation of the QI program ensuring program and procedures support company goals for service, quality, and cost effectiveness as well as compliance with contract, federal and state requirements. Work in close collaboration with and participate in corporate QI activities.

APS Healthcare employees are expected to maintain a positive work atmosphere through communicating and behaving in a manner that is courteous and respectful of customers, clients, co-workers, and supervisors.

ESSENTIAL JOB FUNCTIONS:

1.Implements, monitors and evaluates QI program for APS-Hawaii. Works in concert with corporate and client QI representatives to ensure company and customer compliance requirements are met.

2.Administers the development and maintenance of policies and procedures specific to the Hawaii operation in compliance with NCQA, URAC and other accreditation standards. 

3.Prepares monthly, quarterly and ad hoc QI reports to demonstrate the effectiveness of APS-Hawaii’s quality improvement initiatives. Prepares and manages the annual QI deliverables to client(s) for each contract including but not limited to the Annual BCC QI Program Description, Annual BCC UM Program Description and Evaluation, Annual Delegation Audit and APS Hawaii Workplan.

4.Participates on quality improvement committees to ensure quality issues are taken to the committee and recommendations are made by the committee, in a timely manner. Makes recommendations to the Committee for improving plan operations based on data from performance indicators, QI studies, and quality activities.

5.Serves as a liaison with the customer to ensure delegated QI responsibilities and activities are appropriately being carried out and measured timely. Maintains separate HMSA QI program specifically dedicated to HMSA. Manages and maintains separately, QI program for other customers as application.

6.Supervises assigned QI staff and works with APS departments to ensure that needs are met for QI resources and to ensure operational quality at all levels.

7.Conducts internal audits of charts and clinical/service procedures for QI purposes.

8.Conduct core competency training for staff as needed.

9.Additional assignments or projects as directed by the Vice President.

Qualifications:
Bachelors (or higher) degree, Masters preferred. 

Minimum Experience:
Minimum of 3-5 year’s healthcare quality improvement experience. 

Knowledge in managed behavioral health and accreditation processes preferred.

Other Qualifications:
Knowledge of NCQA and URAC standards and performance measures and quality improvement processes. 

Excellent oral, writing, organization, and critical thinking skills. 

Prior supervisory experience preferred. 

Ability to utilize word processing, spreadsheet, PowerPoint, and database software to enhance data collection, information analysis and report writing.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel as classified.
 

 Country:U.S.
 

 State:Hawaii
 

 City:Honolulu

 


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