NE
Qualitätsmanager:in conducting IVP case reviews and organizing quality discussions. Responsible for quality standards and creating training materials.
About the role
- Provides strategic oversight of all transportation services across NEMT & NMT
- Oversight of the call center, trip scheduling, quality assurance, broker/provider relationships, and regulatory compliance
- Sets long-term goals and departmental direction
- Provides strategic and operational leadership for all aspects of the transportation (NMT & NEMT) program
- Ensures that members receive safe, reliable, and timely transportation services
- Maintains high-quality call center operations and full adherence to federal, state, and contractual requirements
- Commitment to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation
Requirements
- At least five (5) years of leadership experience in NEMT, healthcare operations, call center management, or transportation services required
- Experience in a lead capacity also counts as leadership experience
- Experience managing call center operations, quality teams, and vendor/provider relationships
- Strong knowledge of Medicaid/Medicare NEMT requirements, CMS regulations, HIPAA, ADA, and FWA standards
- Project management and team building experience essential
- HMO, Managed Care setting, or Transportation Operations/industry experience preferred
- Bachelor’s degree in Healthcare, Business Administration, Transportation, or related field from an accredited institution required
- In lieu of the required degree, a minimum of eight (8) years of additional relevant work experience is required for this position
- This experience is in addition to the minimum years listed in the Experience Requirements above
- Master’s degree in MPH, MA, MSN, MBA, or related field from an accredited institution preferred
- Must obtain the NEMTAC Certified Transport Specialist (CTS) certification within six (6) months of hire
- Must have a valid California Driver’s license and valid automobile insurance
- Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points
- Strong knowledge of state and federal requirements and regulations of CMS, DHCS, DMHC, and NCQA
- Knowledge of Medi-Cal managed care
- Understanding and sensitivity to a multi-cultural environment and community
- Strong knowledge of Medi-Cal/Medicare managed health care preferred
- Knowledge of service delivery in a call center environment
- Knowledge of Managed Care Operational systems and procedures
- Proven leadership with ability to manage large, diverse teams across call center and vendor operations
- Strong knowledge of call center workforce management, SLAs, and quality assurance
- Skilled in vendor negotiations, contract management, and provider compliance oversight
- Strong financial management and budget planning experience
- Proficiency in data analytics, Microsoft Office, and Transportation Management Systems
- Excellent communication, conflict resolution, and stakeholder management skills
- Ability to coach and mentor others, must have a high degree of patience, attention to detail, and time management capabilities
- The ability to prioritize competing priorities
Benefits
- Competitive salary
- Hybrid schedule
- State of the art fitness center on-site
- Medical Insurance with Dental and Vision
- Life, short-term, and long-term disability options
- Career advancement opportunities and professional development
- Wellness programs that promote a healthy work-life balance
- Flexible Spending Account – Health Care/Childcare
- CalPERS retirement 457(b) option with a contribution match
- Paid life insurance for employees
- Pet care insurance
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