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National Program/Project Director Medical Record Abstraction/Peer Review



Job Location

Easton, MD

Position Type

Full-Time/Regular

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country.

In addition, our Foundation provides grant opportunities to those with programs for under-served communities.

 

Best People, Best Solutions, Best Results

 

This position is homebased and may be located nationwide.  The position is contingent upon award of contract. 

 

Job Summary:

Plans, directs, and coordinates activities of designated project(s) to ensure that goals or objectives and contract requirements of project are accomplished within prescribed time frame and funding parameters by performing the following duties personally or through subordinates. Responsible for the overall program direction and acts as the primary point of contact between contract representative and Qlarant staff.  Provides leadership, coordination and management to regional managers to fulfill contract aims and tasks. 

 

Essential Duties and Responsibilities:

  • Maintains knowledge of project proposal or plan and provides technical oversight to all phases of project. May contribute to proposal development.
  • Provides oversight of contractual requirements; maintains working knowledge of customer needs and contract requirements, deliverables, resource requirements, budget management; monitors and adheres to cost projections, and continuously explores operational efficiencies. Ensures systems are in place for contract compliance and timely deliverables.  Develops and works with others to utilize management tools to monitor contract performance.
  • Coordinates with Management to ensure the staff has clear direction of the objectives required; Confers with project staff to outline work plan and to assign duties, responsibilities, and scope of authority. Confers with project personnel to provide technical advice and to resolve problems; Directs and coordinates activities of project personnel to ensure project progresses on schedule and within prescribed budget.  Reviews status reports prepared by project personnel and modifies schedules or plans as required.
  • Prepares written reports, articles for publication, and requests for proposals/grants.
  • Conducts meetings of all types, i.e., focus groups and provider meetings, and participates on committees.
  • Works with the government contract oversight coordinator to ensure all aspects of the contract are met as specified in the SOW; Liaisons with contract contacts and other external/internal customers with responsibilities including: facilitating meetings, attending committee meetings, and addressing questions and concerns raised by contractor.
  • Collaborates with the customer to design and adapt processes and deliverables to meet changing needs.
  • Works with subcontractor(s) to develop and implement policies and procedures consistent with requirements of the prime contract.
  • Provides updates and oral presentations regarding contract activity as requires by contract.
  • Encourages staff and management to improve procedures in an effort to maximize production of deliverables including implementing training programs to provide continued learning for staff development.
  • Ensures availability and training of resources. Provides job specific orientation and training when called upon. Works with the manager or others, develops training content, resources and programs specific to job functions.  Documents records of training that includes: scheduling, registration and attendance, quality control of training products and evaluation summaries.

 

Supervisory Responsibilities

  • Is responsible for the overall direction, coordination, and evaluation of their unit/s. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. May manage subordinate supervisors who supervise staff in the operational area.  May also directly supervise non-supervisory employees.

 


Required Skills

 

  • Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures.
  • Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions.
  • Project Management - Develops project plans; Coordinates projects; Communicates changes and progress; Completes projects on time and budget; Manages project team activities.
  • Change Management – Develops workable implementation plans; Communicates changes effectively; Builds commitment and overcomes resistance; Prepares and supports those affected by change; Monitors transition and evaluates results
  • Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
  • Managing People - Includes staff in planning, decision-making, facilitating and process improvement; Takes responsibility for subordinates' activities; Makes self available to staff; Provides regular performance feedback; Develops subordinates' skills and encourages growth; Solicits and applies customer feedback (internal and external); Fosters quality focus in others; Improves processes, products and services.; Continually works to improve supervisory skills.
  • Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.
  • Business Acumen - Understands business implications of decisions.
  • Judgment - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
  • Planning/Organizing - Sets goals and objectives aligned with strategic objectives; communicates this vision; Develops realistic action plans and workable implementation plans; and monitors progress.
  • Delegation - Delegates work assignments; Matches the responsibility to the person; Gives authority to work independently; Sets expectations and monitors delegated activities.
  • Organizational - Organizes resources and manages competing priorities to achieve competing priorities with ability to track multiple projects through time. Takes mitigating steps when required and plans for additional resources.
  • Communication Skills – Ability to communicate effectively in written and verbal formats to a wide variety of parties internal and external to the organization. Ability to present and facilitate large and small groups. Communicates in a timely manner
  • Innovation - Displays original thinking and creativity; Meets challenges with resourcefulness; Generates suggestions for improving work; Develops innovative approaches and ideas; Presents ideas and information in a manner that gets others' attention.



Required Experience

 

  • Prefer at least ten years clinical experience as a Registered Nurse (MSN), Nurse Practitioner (advanced practice nurse) or physician. Strong knowledge of the medical record review, abstraction, peer review and clinical performance measurement/evaluation process.
  • Demonstrated skills in directing and managing large complex multi-healthcare system programs measuring clinical performance. A broad knowledge of, and experience in the VA is desired. Strong knowledge of existing clinical performance measures (TJC, NCQA, etc.).
  • Familiar with a variety of the project management concepts, best practices, and procedures; including vast experience managing and directing delivery, scope, and risks throughout the life cycle of a project. Demonstrated ability to direct and manage multiple engagements over a wide stakeholder community. 
  • Based on contract requirements, specific degree, experience or expertise may be required.

Computer Skills:

  • To perform this job successfully, an individual should have knowledge of Project Management software and other basic office software.

 Other Skills and Abilities:

  • Collaboration and conflict resolution – works with multiple constituencies to ensure they have a voice, while working towards unifying goals. Communicates changes effectively; Builds commitment and overcomes resistance; Prepares and supports those affected by change; Monitors transition and evaluates results.
  • Displays superior management skills and has demonstrated the ability to plan, implement, and monitor contractual requirements.

 

Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.


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