Job Description

Job Summary:

Manages the operational aspects of ongoing projects and serves as liaison between project management and planning, project team. Responsible for coordinating subordinate employee recruitment, selection and training, performance assessment, work assignments, and recognition/disciplinary actions. Oversees the status of operational issues, manages schedules and prepares reports. Monitors and develops resolutions to meet productivity, quality, and client-satisfaction goals and objectives.

Essential Duties and Responsibilities:

• Responsible for the specific team performance in order to achieve the operational goals of timeliness, quality, and customer service
• Identify and maintain appropriate staffing levels
• Responsible for coordinating subordinate employee recruitment, performance assessment, work assignments, salary, and recognition/disciplinary actions
• Manage processes and procedures to ensure timely and quality completion of work according to clients contractual obligations
• Responsible for the daily operational workflow, to include communication with external and internal customers, resolution of customer issues, and identify workflow concerns for specific cases and employees
• Ensure the use of best practice workflows and operational excellence in activities are utilized and seeks methods of automating recurring processes
• Direct the training of team members on workflow and contractual modifications expeditiously
• Manage processes focused on effective customer service, ensure immediate escalation of issues, and participate in meetings to discuss the medical records process
• Analyze and report on a monthly and quarterly basis operational statistics
• Administer and monitor cost effective fiscal controls and services
• Assist in providing timely and exceptional training for our providers (medical professionals) in QTC\xe2\x80\x99s network
• Responsible for monitoring and managing operational expenses (OPEX)
• Perform other duties and responsibilities as assigned

Competencies:

• Strong leadership skills with the ability to prioritize and delegate effectively
• Sound knowledge and understanding of medical terminology and body systems
• Possess and demonstrate skills necessary to analyze information, problems, procedures and situations
• Strong working knowledge of electronic scheduling systems and Electronic Medical Records (EMR)
• Strong working knowledge of case management programs

Education and/or Experience: (includes certificate & licenses)

• Bachelor\xe2\x80\x99s degree from an accredited college preferably in a healthcare related field or equivalent experience/combined education
• 7 years of managed care/medical case management experience
• Project management and medical case management life cycle experience is preferred
• Must be able to successfully pass National Agency Check with Inquiries (NACI) background investigation

This job description supersedes all prior job descriptions and is intended to describe the general content and essential requirements for the position listed above. It is not to be construed as an exhaustive statement of requirements, duties and responsibilities. Management reserves the right to add or change the duties of this position as required at any time.

QTC Management Inc. is a VEVRAA Federal contractor and an Equal Opportunity Employer. The company has an ongoing commitment to affirmative action and the creation of a workplace free of discrimination, harassment and retaliation. The company recruits, hires, trains, and promotes individuals in all job titles without regard to race, color, creed, religion, ancestry, national origin, age, sex, sexual orientation, people with disabilities protected under law, and protected veteran status.

Experience Required

• 7 year(s): Managed care/medical case management experience.

Education Required

• Bachelors or better

Skills Required

• Leadership
• Executing Multiple Tasks
• Problem Solving

Preferred

• Written Communication
• Verbal Communication
• Critical Thinking
• Computer Literacy
• Analytical
• Electronic Medical Records
• Medical Terminology

Behaviors Preferred

• Leader: Inspires teammates to follow them
• Functional Expert: Considered a thought leader on a subject
• Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well

Motivations Preferred

• Job Security: Inspired to perform well by the knowledge that your job is safe
• Goal Completion: Inspired to perform well by the completion of tasks
• Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor\xe2\x80\x99s legal duty to furnish information. 41 CFR 60-1.35(c)

QTC Management