Life Underwriting Director jobs in Fayetteville, NC

Complete lifecycle management for quality adherence and process cohesiveness throughout the organization. Ensure proper documentation for all records.

Position Responsibilities

· Create and implement a methodology to meet and exceed standards set forth by the MCOs, State of NC and national accrediting bodies. Seek MCO Gold Standard

· Interact with the reviewers from the MCOs, State of NC and accrediting bodies

-Develop and Create Policies and Procedures, Plan of Corrections

· Implement and verify all documentation processes are followed and documentation standards met for intakes, transitions, outcome measurement and HR

· Oversee the QA/QI, Client’s Rights, and peer review committees to ensure that required standards, guidelines and documentation are met

· Remain current and well versed on changes and updates that affect the organization by monitoring regulatory agency websites, Medicaid bulletins, emails and any other communication method designed to articulate updates and changes

· Ensure organization is compliant with all current / changing regulations

· Work with management to implement best practices for organization and treatment

· Ensure that all staff / TFP’s are meeting training requirements set forth by the licensing body

· Ensure the clinical privileging, supervision and training of staff / TFP is well documented in the personnel / TFP records

· Keep management informed of changes and challenges that affect the organization

-Produces QM documents, including tracking and updating Work Plan activity progress.

-Maintain and monitor Foster Parents and Client Charts to ensure that they maintain full compliance

• Implements corporate policies and creates local quality addenda and SOPs when needed.

• Produce and oversee production of client and contractual reports and reports required for meeting accreditation standards.

• Provide Quality thought leadership to Sales teams/RFPs, and creates quality-related articles for members and providers.

• Ensures ongoing compliance with accreditation (NCQA and URAC) standards.

• Leads and/or chairs quality committees.

• Serves as the lead for the Cultural and Linguistics program within assigned territory. Leads quality performance improvement, implementation, and program development to support accreditation including developing, implementing, monitoring and tracking performance of regional quality programs. Participates with Corporate Quality and other regional Quality leads in the charter of Quality Improvement Activities (QIA) to support accreditation.

• Oversee QIA program development. • Leads Quality projects in collaboration with clients.

• Tracks performance of Core Performance Indicators (CPIs).

• Collaborates with health plan clients on HEDIS measures measurement and improvement opportunities. Collaborates with Corporate Quality on HEDIS rate production and client deliverables.

• Monitors Service Level Agreements (SLA) relating to quality and implements and monitors Corrective Action Plans and collaboration with internal stakeholders, clients, and providers.

• Implements and monitors related to Corporate Quality as well as external client delegation and regulatory audits for accreditation readiness.

• Hires, trains, coaches, counsels, and evaluates performance of direct reports.

· All other duties as may be assigned

Position Requirements

BS/BA Degree, preferably in the Mental Health field

Minimum 3 years of experience in Quality Management

Knowledgeable of Mental Health regulatory requirements

Familiar with TFC documentation requirements

Self-starter, detail oriented, good interpersonal skills, great communicator

Able to work with others to get desired results

Job Types: Full-time, Part-time

Pay: $18,000.00 - $55,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Work Location: In person