Sr Manager - Quality Management Enrollment Broker HCO - Remote CA - Maximus

Description & Requirements

Since 1997, Maximus has served as the enrollment broker for the nation's largest Medicaid program, California's Medi-Cal, California Health Care Options (HCO). In support of the HCO program's goals, we provide Medi-Cal applicants and beneficiaries with accurate, unbiased health information and assist with their health plan selection and enrollment.

Come join Maximus and be a contributing Management Team member for the California Health Care Option Program.

This is a remote position.

Adhering to state requirements, candidates must reside within California. Out-of-state candidates are not eligible for this role.

Essential Duties and Responsibilities:

- Develop and oversee an effective management system to continuously identify opportunities for improvement while maintaining adherence to contract driven key performance indicators.

- Direct all Quality Control and Quality Assurance management operations including planning, implementation monitoring and reporting functions to ensure compliance objectives and targets are achieved.

- Develop and oversee an effective quality control and assurance systems for Operations to continuously identify opportunities for improvement while maintaining adherence to contract driven key performance requirements.

- Manage all Quality Control and Quality Assurance staff including Managers, Supervisors, and Analyst(s).

- Direct all quality management operations including planning, implementation, monitoring, and reporting functions.

- Collaborate with technical staff to design and develop reports.

- Distribute reports and background information to staff and external sources as required.

- Extract, aggregate, pivot, review, analyze and present data in various formats to management.

- Interact with Management and Operations to summarize findings

- Analyze existing systems, programs, policies, and organizational processes.

- Document "best practices" and continuously measure outcomes for desired results and improvements.

- Travel up to 50 percent of the time as needed.

- Develop and deliver quality control and quality assurance training for all employees engaged in quality and performance monitoring.

- Monitor all operations and related metrics for conformance with internal, external, contract performance, and quality standards.

- Aggregate and analyze quality data and suggest methods for improving product and service quality, design and/or business processes.

- Schedule and coordinate all the quality and performance monitoring activities of QA staff across the project.

- Manage internal and external clients' expectations related to quality management, and effectively communicate corporate quality standards across the project.

- Provide feedback on requirements and functional specifications.

- Monitor and evaluate the effectiveness of all areas of project operations and reports quality issues to project and unit management.

- Maintain an awareness of state and federal quality assurance practices and provide all project teams with updates on all issues regarding quality.

- Produce quality assurance and performance reports as required by contract and project operations.

- Perform other duties as assigned by management.

• Develops contractual and quality assurance oversight systems and goals and implements specific objectives to ensure oversight systems are adequate and goals are realized.
• Full authority and final responsibility for ensuring that all activities conform to the established Quality Management System.
• Develops and maintains positive and effective communications with the Department of Health Care Services (DHCS).
• Develops controls and provides direct oversight of all contractual and quality assurance functions.
• Performs timely reviews of staff in accordance with policy and makes recommendations for pay raises, bonuses, and the awards program based on approved policies and procedures for such.
• Ensures that the HCO Project is in compliance with the contract and all required facets of State and Federal regulatory requirements.
• Ensures quality standards are established, communicated, monitored, and maintained for each HCO functional area.
• Ensures contractual and quality assurance daily, weekly, monthly, and yearly reporting requirements are developed, met, and maintained.
• Audits required contract provisions and ensures contract compliance standards are identified and met.
• In accordance with ISO 9001, organizes and develops Management Reviews at planned intervals to ensure the Quality Management System's (QMS) continuing suitability, adequacy, and effectiveness.
• Conducts various types of analyses including data, feasibility, technical, and workflow processes.
• Extrapolates audit report findings and prepares reports of audit findings which identify impacts, trends, and recommendations and provides project management with feedback on process or staff effectiveness.
• Maintains updated knowledge of contract compliance provisions for the project and department as well as ISO 9001 and serves as a resource for the CA HCO Project on such requirements.
• Directly oversees the ISO 9001 Internal Quality Audit Program.
• Directly oversees the Problem Correction Process and ensure that all the contractual and QMS requirements in this process met.
• Performs other duties as may be assigned by management.

Minimum Requirements

- Bachelor's degree in relevant field of study and 7+ years of relevant professional experience required, or equivalent combination of education and experience.

Additional Minimum Requirements:

• Bachelor's degree from an accredited college or university in business administration, economics, applied mathematics, or relevant years of experience.
• Three-to-five years experience in quality management and managing quality assurance functions, preferably in a health and/or human services related environment.
• Computer literacy.
• Excellent people management skills
• Excellent organizational, interpersonal, written, and verbal communication skills.
• Ability to perform comfortably in a fast-paced, deadline-oriented work environment.
• Ability to successfully execute many complex tasks simultaneously.
• Ability to work as a team member, as well as independently
• Strong analytical background.

Preferred qualifications:

• Master's degree from an accredited college or university.
• Knowledge of or experience in working with the State of California contracting and auditing processes.
• Two years of experience in Quality Assurance, Internal Auditing, or Accounting in a healthcare or services-based environment.
• Certified Manager of Quality/Organizational Excellence.
• ISO 9001 Lead Auditor Certification.

EEO Statement

Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We're proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.

Pay Transparency

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.

Minimum Salary

$

100,000.00

Maximum Salary

$

135,000.00