The Carolinas Center for Medical Excellence (CCME) seeks an EQR Project Manager to be responsible for supervising staff assigned to the Medicaid EQR service area, and ensuring accuracy, integrity, and compliance. The position will oversees work performed by professional staff, handles the scheduling and flow of work, monitors the volume and accuracy of work performed by assigned staff, and submits reports as directed. Responsibilities include recruiting, hiring, and training qualified staff for necessary duties.
The role serves as the primary liaison for CCME with the NC DHHS Division of Medical Assistance. The successful incumbent will maintain professional working relationships with health plans, Medicaid agency contract staff and program leaders; proactively assist with the development of plans and activities to increase EQR contract opportunities; and provide maximum value to the customer.
Must have the ability to travel to and within NC regularly and preference will be given to candidates located in the southeastern region of the US.
Equal opportunity employer of protected veterans Equal opportunity employer of individuals with disabilities We do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, gender identity, national origin, medical condition, disability, veteran status, or any other basis protected by law. Applicants and employees are protected from discrimination based on inquiring about, disclosing, or discussing compensation or the compensation of other applicants or employees.
Applicants must meet the following requirements: • Graduate of accredited college or university, with degree in Behavioral Health or Social Sciences • Licensure or certification as specific by contract. • Five (5) years of management experience and in offsite and onsite EQR activities • Experience in each of the following: o Medicaid recipients, policies, data systems and processes o Managed care delivery systems, organizations and financing o Quality assessment and improvement methods o Research design and methodology, including statistical analysis • Ability to function independently and coordinate review activities • Superior written and oral communication skills
The Carolinas Center for Medical Excellence (CCME) provides services that help advance the quality and cost effectiveness of health care in the southeastern United States. Through collaboration, education, and leadership, we work with medical and clinical professionals, providers, state and federal agencies, and consumers across the health care continuum to ensure the quality, cost effectiveness, and accessibility of health care.