Acentra Health
Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes ā making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.
Acentra Health is looking for a Quality, Manager - RN - Full-time (Remote within Alaska Time Zone Hours) to join our growing team. Job Summary: Responsible for overseeing day-to-day operations of Quality Management or for the development and monitoring of quality monitoring activities. Develop, implement, and monitor our organization's quality and performance improvement activities and clinical outcomes. You will play a key role in supporting both medical and behavioral health departments in delivering high-quality care. PLEASE NOTE: * This role is contingent upon being awarded a contract. Start dates and final offers are contingent upon the contract award and final contract start dates. *
Required Qualifications/Experience: Must be available to work business hours as defined by contract within the Alaska Time Zone. An active, unrestricted Licensed Registered Nurse (RN) in the State of Alaska. OR the ability to obtain Alaska RN state licensing within three months of your start date, if selected. Bachelorās Degree in a related healthcare discipline. Formal training or certification in Quality (e.g., CPHQ, ISO, Six Sigma). 5+ years of experience in healthcare, preferably with service authorization/prior authorization experience. Knowledge of National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Commission (URAC) and CMS frameworks for quality standards. Preferred Qualifications/Experience: Residency within Alaska, Pacific, OR Mountain Time Zone. Experience with Medicaid, Medicare, or commercial health plans.
Facilitate Quality Assurance (QA) activities, provide continuous improvement consulting services to internal customers, employ knowledge of performance improvement strategies, principles, methodology, techniques, and data analysis. Ensure the implementation of key performance indicators and maintains systems for tracking, reporting and improving performance. Ensure the promotion of awareness of customer requirements throughout the operation. Review audit results and identify the severity of audit findings or the risk associated with the findings. Review and evaluate reported crisis (i.e., highly urgent service-related problem with immediate negative implications for the Company) and assists with the formulation of a plan of action for handling the incident/issues based on area of expertise/responsibility. Execute QA plans to ensure they meet current and future business requirements (e.g., best practices, quality, volume and product growth, regulatory requirements, & new product introductions). Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules. The above list of responsibilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.
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