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Pines Behavioral Health

Provider Network / Quality Improvement Manager

Career Insights for Clinical Quality Manager

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What they do

A Clinical Quality Manager ensures that the quality of the work in a clinical environment is consistent and meets government and industry standards as well as customer expectations. Verifies compliance with health and safety regulations. Coordinates all activities related to quality assurance and monitoring and revises existing processes in order to increase efficiency.

$124,369 / year median in Michigan

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Job Description

Pines Behavioral Health is seeking a full-time management position (40-hour day shift) Provider Network and Quality Management.
Starting Salary range:
$85,542 -$98,791 based on experience and licensure. This position is ideal for a candidate recognizes the importance of behavioral health quality and wants to make a difference in the lives of persons with serious mental illness, and intellectual / developmental disabilities. This leadership position is responsible for the following:
Provider Network:
Evaluating the adequacy of network providers to serve persons with a serious mental illness or intellectual/developmental disability on an ongoing basis Working with third party insurers on agency paneling Credentialing and subsequently negotiating a mutually beneficial contract with providers Providing guidance and communication with providers Monitoring the performance of providers, assisting in the ongoing quality of services provided
Quality Management:
Implementing the Continuous Quality Improvement program across the agency as well as the provider network. Assisting the development of the Strategic Plan and creating the resulting Quality Improvement Plan Monitoring key performance indicators related to CCBHC, Waiver programs, and grants, communicating results and strategies for improvement Conducting ongoing feedback and communication systems internal and external stakeholders Preparing and coordinating quality audits including CARF, CCBHC, PIHP, and MDHHS audits
Qualifications:
Master's Degree in a Human Services field (required) and Professional Licensure strongly preferred: Licensed Masters Social Worker (LMSW); Limited Licensed Psychologist (LLP); Licensed Professional Counselor (LPC); Limited Licenses (LLMSW, LLPC) may be considered. Minimum of 3 years' experience professional work experience in behavioral health Knowledge of the principles of continuous quality improvement, negotiation/contracting, compliance, and risk management Advanced computer skills including word processing, spreadsheets, data dashboards, tableau, and graphs Driver's license required and reliable transportation Pines Behavioral Health is an equal opportunity employer.
Pay:
$85,542.00 - $98,791.00 per year
Benefits:
401(k) 401(k) matching AD&D insurance Dental insurance Flexible schedule Flexible spending account Health insurance Life insurance Loan repayment program Paid time off Professional development assistance Retirement plan Tuition reimbursement Vision insurance
Work Location:
In person