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Senior Quality Specialist in San Diego, CA at Pride Health

Date Posted: 5/16/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    San Diego, CA
  • Experience:
    Not Specified
  • Date Posted:
    5/16/2019

Job Description

Pride Health is seeking a Behavioral Health Quality Specialist to work with a top managed health organization in San Diego. The Behavioral Health Quality Specialist will coordinate projects resulting in continuous quality improvement and process improvement of behavioral healthcare. 

Responsibilities:

  • Serves as quality improvement specialist for the quality program with the goal to meet customer requirements and performance guarantees. 
  • Coordinate quality, accreditation and delegated initiatives and project plans, monitoring and execution to meet timely deliverables. 
  • Provides direct interventions with members and providers to address gaps in care.
  • Develops, in collaboration with the customer and communication department, informational and training materials for providers and members.
  • Coordinates with any vendors outreach and interventions.
  • Prepares status reports on activities and outcomes of interventions and activities.
  • Consults and trains staff on measurement specifications.
  • Provides assistance as needed in data maximization efforts through coordination with the company's Central HEDIS team.
  • Coordinates CQI (continuous quality improvement) processes and studies related to improved outcomes.
  • Provides interface with customers, National Quality/Clinical and CCOE staff for HEDIS planning, reporting and program enhancements.

Requirements:

  • Bachelor’s Degree in Healthcare, Public Health or a related field.
  • CA Behavioral Health License required (LCSW, LMFT, LPCC, or Psychologist certification)
  • 1-3 years of experience of quality improvement and auditing in healthcare.
  • CPHQ preferred.

Interested? Apply online or email sarah.campbell@pride-health.com.