Top Quality Management Executive - Healthcare jobs in New York, NY

Clinical Quality Manager

ROLE: The Clinical Quality Manager holds an integral position for our clinical team, working to ensure clinical quality in our assessments and documentation, provide feedback to BCBAs, and identify strategies for providing effective training and support. The Clinical Quality Manager works in collaboration with the Chief Clinical Officer, as well as with other Clinical Quality Managers, Case Managers, and BCBAs.

RESPONSIBILITIES (Include, but are not limited to):

• Review and provide feedback on initial assessments and reassessments written by BCBAs.

• Assist BCBAs in correcting errors on assessments to ensure insurance approval.

• Collect signatures from parents and BCBAs once the report is complete.

• Update Assessment templates based on changes to insurance regulations.

• Keep track of open authorizations to ensure there are no lapses in coverage and assessments are submitted on time.

• Liaise with the Case Manager if assessments were not submitted within 2 weeks of authorization expiration.

• Assist with insurance calls and peer reviews.

• Meet as needed with the Regional Clinical Manager to report issues that are seen with the assessments.

• Meet weekly with the Chief Clinical Officer (CCO) .

• Monthly reports on assessments and updates to insurance guidelines.

REQUIREMENTS:

Qualifications: BCBA with a minimum of one year of experience working within the insurance model; strong interpersonal and communication skills; excellent computer skills; detail-oriented; ability to work independently; reliable with deadlines; dedication to ensuring the highest quality of care for individuals with autism and developmental disabilities.

Skills: Operational abilities: Critical thinking and analytic skills; ability to identify potential solutions; ability to organize materials and resources; Strong written, oral, interpersonal skills, and an aptitude for following directives. Self-awareness: Interest in self-refinement, and willingness to accept and apply feedback appropriately

Supervision: Clinical Quality Manager reports directly to the CCO.

Work Schedule: 40-hour general weekly schedule. Monday-Friday, 9 AM - 5 PM.

Work Environment: Work will be performed within the office. Must have reliable transportation.

Communication Skills: Advanced written, oral, and interpersonal skills. Compelling communication style to advocate for client needs.

Computer Skills: Proficiency in Gmail, Word, and Excel.

Reasoning Ability: Ability to make determinations of best procedures and practices to attain goals of the position.

Working Conditions: This is an exempt, salaried position, where regardless of hours worked, the goals of the work is completed in its entirety.

Physical Demands: Ability to perform extended desk-work, and handle the necessary physical demands of actively supporting, lifting, and working in indoor and/or outdoor settings. This includes, among others, sitting, kneeling, crawling, and lifting up to 25 lbs, as needed.

Salary Range: $90,000-$110,000

Clinical Quality Manager:

Traits required for this role:

Values that are essential for this role and experience: