Manager of SoonerSelect Quality
Core
Operational and technical oversight of quality activities for the SoonerSelect managed care program, including medical plans, Children's Specialty Program, and Dental Benefit Plans.
Role type
Manager of Managed Care Quality
Builds
Quality reports, performance analyses, and improvement plans for Medicaid managed care entities.
Domain
Healthcare / Medicaid Managed Care
Deliverable
dashboards & analysis
Required skills
Data analysis, Performance improvement project oversight, Contract monitoring, Stakeholder engagement, Regulatory compliance, Report review, Team supervision, Trend analysis, Survey management
Preferred skills
Clinical license, Managed care administration, Vendor management, Compliance auditing, Project management certification, HEDIS/CMS Core Set measures experience, External Quality Review Organization experience
Technologies
MCI, CORETechs, CAHPS, EQRO
Responsibilities
Manage day-to-day quality oversight for contracted Managed Care Entities; Review quality reports to identify deficiencies and trends; Monitor MCE performance using data sources and scorecards; Oversee Performance Improvement Projects (PIPs); Coordinate member and provider experience surveys; Support External Quality Review Organization (EQRO) contract monitoring; Facilitate Quality Advisory Committee activities.
Seniority
Manager, hands-on leadership