Quality Improvement Director. The QI Director must: Be an Ohio-licensed registered nurse, physician, or physician's assistant, or be certified as a Certified Professional in Health Care Quality by the National Association for Healthcare Quality (NAHQ), Certified QI Associate by the American Society for Quality, and/or Certified in Health Care Quality and Management (CHCQM) by the American Board of Quality Assurance and Utilization Review Providers prior to employment or within six months of the date of hire; Have experience in quality management and quality improvement as specified in 42 CFR 438.206 through 438.370; and Report directly to the Medical Director/CMO. The primary functions of the QI Director are to: Develop and manage the MCO's portfolio of improvement projects, including ensuring impact at a population level and identifying and prioritizing initiatives to align with ODM's Quality Strategy; Oversee MCO improvement teams and coordinate QI training for MCO staff; Reinforce the application of QI tools and methods within MCO improvement projects and initiatives; and Ensure that learning from all improvement projects and initiatives are shared with ODM and XXX's contracted managed care entities. Care Coordination Director The Care Coordination Director must be an Ohio-licensed registered nurse or an Ohio-licensed independent social worker in good standing, preferably with a designation as a Certified Case Manager from the Commission for Case Manager Certification. The Care Coordination Director must have experience in the activities of care management as specified in 42 CFR 438.208. The Care Coordination Director must report through the Medical Director/CMO. The primary functions of the Care Coordination Director position are to: Oversee the day-to-day operational activities of the Care Coordination Program in accordance with state guidelines. The Care Coordination Director is responsible for ensuring the functioning of care coordination activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating); Implement mechanisms for identifying, assessing, and developing treatment plans for members with special health care needs; Ensure access to primary care, behavioral health, and coordination of health care services for all members; Serve as the MCO's primary point of contact for the OhioRISE Plan on care coordination; Develop and implement processes and resources for providing support to members who opt out of care coordination...
Quality Improvement Director. The Contractor must employ a full-time Quality Improvement Director, located in Illinois, who is an Illinois licensed physician, or Illinois licensed registered nurse, or another licensed clinician as approved by the Department based on the plan’s ability to demonstrate that the clinician possesses the training and education necessary to meet the requirements for quality improvement activities required in the Contract. The Quality Improvement Director must, at a minimum, be responsible for directing the activities of the quality improvement staff in monitoring and auditing the Contractor’s healthcare delivery system to meet the Department’s goal of providing health care services that improve the health status and health outcomes of its Enrollees. Plans with low membership must meet the following guidelines: under 7,500 membership a .25 full-time position; between 7,500 and 15,000 membership a .50 full-time position.
Quality Improvement Director. 1. The Quality Improvement (QI) Director must: Be an Ohio-licensed registered nurse, physician, or physician's assistant, or be certified as a Certified Professional in Health Care Quality by the National Association for Healthcare Quality (NAHQ), Certified Quality Improvement Associate by the American Society for Quality, or Certified in Health Care Quality and Management (CHCQM) by the American Board of Quality Assurance and Utilization Review Providers prior to employment or within six months of the date of hire; A minimum of two years' experience in a senior QI role in child/adolescent behavioral health managed care is required; Have experience in quality management and quality improvement as specified in 42 CFR 438.206 through 438.370; and Report directly to the Medical Director/CMO.
Quality Improvement Director. 1. The QI Director must: Be an Ohio-licensed registered nurse, physician, or physician's assistant, or be certified as a Certified Professional in Health Care Quality by the National Association for Healthcare Quality (NAHQ), Certified QI Associate by the American Society for Quality, and/or Certified in Health Care Quality and Management (CHCQM) by the American Board of Quality Assurance and Utilization Review Providers prior to employment or within six months of the date of hire; Have experience in quality management and quality improvement as specified in 42 CFR 438.206 through 438.370; and Report directly to the Medical Director/CMO.
Quality Improvement Director. Individual shall be responsible for all QAPI program activities. Individual shall have relevant experience in quality management for physical and/or behavioral health care and shall participate in regular Quality Improvement meetings with DHHS and the other MCOs to review quality related initiatives and how those initiatives can be coordinated across the MCOs.
