MAXIMUS

Quality Director - Healthcare

Job Locations US-CA-Sacramento
Posted Date 2 months ago(12/30/2017 8:37 AM)
Requisition ID
2017-28735
# of Openings
1
Job Function
Quality
Job Schedule
Regular Full-Time

Project/Position Introduction

*Employment is contingent upon contract award.

Overview

The Director of Quality Management will provide the vision and leadership to develop and implement a comprehensive quality management discipline.

Responsibilities

  • Principal manager for setting strategy and vision for the Contract’s QM activities including Quality Assurance, Quality Control and reporting.
  • Responsible for communication and coordination across all Business Services across the Contractor’s Operations, as well as communication with DHCS and its independent QM contractor for all matters pertaining to quality of service delivery.
  • Plays a critical role in providing data, system and operational procedures, operational manuals, and any other access to DHCS and its independent QM contractor during independent audits.
  • Responsible for facilitating unlimited and absolute transparency into all aspects of the Contractor Operations and performance.
  • Develops contractual and quality assurance oversight systems and goals and implements specific objectives to ensure oversight systems are adequate and goals are realized.
  • Full authority and final responsibility for ensuring that all activities conform to the established Quality Management System.
  • Develops and maintains positive and effective communications with the Department of Health Services (DHCS).
  • Develops controls and provides direct oversight of all contractual and quality assurance functions.
  • Performs timely reviews of staff in accordance with policy and makes recommendations for pay raises, bonuses, and the awards program based on approved policies and procedures for such.
  • Develops QA systems and ensures that the CA MMIS Fiscal Intermediary Business Operations (CA MMIS FIBO) Project is in compliance with the contract and all required facets of State and Federal regulatory requirements.
  • Ensures quality standards are established, communicated, monitored, and maintained for each CA MMIS FIBO functional area.
  • Ensures contractual and quality assurance daily, weekly, monthly, and yearly reporting requirements are developed, met, and maintained.
  • Audits required contract provisions and ensures contract compliance standards are identified and met.
  • Organizes and develops Management Reviews at planned intervals to ensure the Quality Management System’s (QMS) continuing suitability, adequacy, and effectiveness.
  • Conducts various types of analyses including data, feasibility, technical, and workflow processes.
  • Extrapolates audit report findings and prepares reports of audit findings which identify impacts, trends, and recommendations and provides project management with feedback on process or staff effectiveness.
  • Maintains updated knowledge of contract compliance provisions for the project and department as well as ISO 9001 and serves as a resource for the Project on such requirements.
  • Performs other duties as may be assigned by management.

The Ideal Candidate will Possess the Following Additional Education and Experience

  • A Bachelor’s degree and a minimum of four (4) years of quality management (QM) experience (additional relevant management experience may substitute for the degree on a year-for-year basis).
  • QM experience shall be specific to a large-scale operation equal in size and complexity to the organization depicted in this Contract, with an emphasis on customer and service delivery.
  • Two (2) years of MMIS or government, or private sector healthcare payer experience.
  • Exemplary customer service skills.
  • Excellent verbal, written, and presentation communications skills.;
  • Excellent organizational, interpersonal, written, and verbal communication skills; ability to perform comfortably in a fast-paced, deadline-oriented work environment; ability to successfully execute many complex tasks simultaneously; and ability to work as a team member, as well as independently; strong analytical background. 
  • Preferred qualifications include a Master’s degree from an accredited college or university; and knowledge of or experience in working with the State of California contracting and auditing processes;
  • Two years of experience in Quality Assurance, Internal auditing, or Accounting in a health care or production based environment;
  • Certified Manager of Quality/Organizational Excellence, and an ISO 9001 Lead Auditor Certification.

 

EEO Statement

EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies MAXIMUS deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We’re proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you

A committed and diverse workforce is our most important resource.

MAXIMUS is an Affirmative Action/Equal Opportunity Employer.

MAXIMUS provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.

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