Location: Columbia,SC, USA
Job Responsibilities
* This position is a repost. Previous applicants do not need to reapply.*
* This is a Temporary Grant position.*
The Agency's mission is to be boldly innovative in improving the health and quality of life for South Carolinians.
This position is located in Bureau of Quality, Richland County.
Are you the One? We are looking for a Assistant Bureau Chief of Quality, who will be responsibble, in collaboration with the Bureau Chief of Quality, for managing the agency's health quality improvement activities, assessing health plan and provider quality status, and establishing and monitoring quality improvement goals. This individual reports directly to the Bureau Chief of Quality and assists in the management of a Bureau responsible for informing the agency's executive team on matters related to the Quality goals of the Agency. This individual also works with SCDHHS medical director and other clinical staff on matters related to quality and population health.
* Assists in the development and management the SCDHHS Quality Strategy, including all related quality improvement policies and activities aimed at ensuring that the quality of care delivered to SC Medicaid members meets or exceeds agency goals. Liaison with CMS on all SCDHHS quality initiatives and required reports.
* Assists in the oversight of the quality-related components of the Medicaid/Medicare MCO contract(s), including the MCO Withhold and Bonus Program. In this capacity, provides timely and accurate feedback to the MCOs regarding the quality of care provided and general quality trends noted within the SC Medicaid program. Oversees management of EQRO contract and QI initiatives.
* Works within SCDHHS and other South Carolina health care payer systems to design and/or provide input into state initiatives related to population health, various cost containment strategies and evidenced based clinical interventions, as well as SCDHHS internal policy.
* Serves as an internal expert on clinical quality, working frequently with a wide range of clinical and non-clinical colleagues to drive SCDHHS's overall quality strategy and appropriateness of interventions at a system and individual level. Assists in the development of an operational plan that governs the roles and responsibilities of clinical monitoring for Medicaid programs, including HCBS waivers.
* Assists the Agency's community initiatives (e.g. QTIP) to develop clear goals and measurement for Medicaid-wide program improvements. Assists in the development of strategies to apply lessons learned in the managed care delivery system to further improve quality measures.
* Performs fundamental supervisory and leadership functions in accordance with Department policies and procedures, best practices and Federal and State rules and regulations, especially with regard to Equal Employment Opportunity Commission (EEOC) standards. Maintains an effective organizational team and motivates diverse staff to accomplish mission critical operations and objectives. Promotes workforce engagement.
The South Carolina Department of Health and Human Services offers an exceptional benefits package for FTE and TGE positions that includes:
* Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children.
* 15 days annual (vacation) leave per year.
* 15 days sick leave per year.
* 13 paid holidays.
* State Retirement Plan and Deferred Compensation Programs.
Minimum and Additional Requirements
A bachelor's degree in healthcare, Nursing, Health Administration, Public Health, or a related health field and five (5) years of experience directly related to healthcare delivery and/or healthcare quality improvement.
PREFERRED QUALIFICATIONS: Master's Degree in Healthcare, Nursing, Health Administration, Public Health, or a related health field. Five (5) or more years of work experience overseeing contract management staff. Experience working with Medicare and/or Medicaid programs. Five (5) years of experience in a managed care organization. Experience working with a Medicaid program. Five years middle management experience
Additional Requirements:
* Occasional overnight travel.
* Sitting or standing for long periods of time.
* Lifting requirements: 20 lbs.
Preferred Qualifications
* Knowledge of NCQA/HEDIS quality standards.
* Knowledge of state and federal laws and regulations relevant to healthcare delivery and health quality.
* Strong written and verbal communication skills.
* Understanding of analytical methods relevant to quality measurement and improvement.
* Ability to work in a fast-paced, quickly changing environment.
* Ability to quickly and clearly transform abstract ideas and direction into clear goals and tasks.
Additional Comments
Please complete the State application to include all current and previous work history and education. A resume will not be accepted nor reviewed to determine if an applicant has met the qualifications for the position. Supplemental questions are considered part of your official application for qualification purposes. All applicants must apply online. All correspondence from the Office of Human Resources will be through electronic mail.
The South Carolina Department of Health and Human Services is committed to providing equal employment opportunities to all applicants and does not discriminate on the basis of race, color, religion, sex (including pregnancy, childbirth or related medical conditions, including, but not limited, to lactation), national origin, age (40 or older), disability or genetic information.