Regional Claims Manager jobs in Carson City, NV

Job Duties and Responsibilities:

• Ensure Quality of Care: Manage and oversee the quality of care provided to individuals with developmental or behavioral impairments within the designated territory.

• Knowledge of Programs and Regulations: Possess a strong working knowledge of county and state programs, as well as regulatory and legal requirements related to healthcare, special needs services, and behavioral health.

• Track Record of Performance: Demonstrate a proven track record of delivering on key performance indicators (KPIs) related to quality of care, compliance, and service delivery.

• Implement Quality Improvement Initiatives: Identify areas for improvement in service delivery and quality of care, and develop and implement initiatives to address these areas.

• Utilize Technology: Utilize technology solutions and tools to track and monitor quality metrics, streamline processes, and enhance service delivery effectiveness.

• Collaborate with Stakeholders: Collaborate with internal teams, external partners, and regulatory agencies to ensure compliance with quality standards and regulations.

• Training and Development: Provide training and support to staff members to ensure understanding and adherence to quality standards and best practices.

• Continuous Improvement: Stay abreast of industry trends, best practices, and emerging technologies in community services, special needs, healthcare, and behavioral health, and incorporate them into quality assurance processes.

Qualifications:

• Bachelor's degree in Healthcare Administration, Social Work, Psychology, or related field. Master's degree preferred.

• Minimum of 5 years of experience in quality assurance or related field, preferably in the community service, special needs, healthcare, or behavioral health sectors.

• Strong understanding of county and state programs, regulatory requirements, and legal standards related to healthcare, special needs services, and behavioral health.

• Excellent communication, interpersonal, and leadership skills, with the ability to collaborate effectively with diverse stakeholders.

• Proficiency in utilizing technology solutions and tools for data analysis, reporting, and quality improvement initiatives.

• Ability to travel within the designated territory as needed.