External Quality Review (EQR) Contract Manager
About the position The External Quality Review (EQR) Contract Manager is responsible for the effective and efficient operation of assigned contracts and services within Constellation Quality Health. This role involves overseeing contract activities, ensuring high-quality deliverables, and identifying business opportunities to maximize customer value. The position requires strong leadership skills and the ability to manage diverse teams while maintaining professional relationships with various stakeholders. Responsibilities • Oversee and coordinate all contract/business activities, ensuring customer deliverables are met and of the highest quality. • Develop, train, and cross-train contract staff; monitor productivity, schedules, volume, quality and accuracy of end products and reports, timeliness of deliverables; and address performance issues as needed. • Act as primary contact, meeting facilitator, and resource for contractual questions/discussions. • Analyze program systems and processes to identify opportunities for efficiencies and develop solutions. • Develop and manage budgets. • Provide subject matter expertise for service line proposals. • Monitor contract performance, identify future business opportunities, and develop process improvements and enhancements. Requirements • Bachelor's degree required; Master's degree preferred. • Ten (10) years of related experience. • CPHQ or other advanced certification (Project Management, HEDIS, Utilization Management, etc.) required. • Five (5) years' experience in related contract work and/or quality management in a leadership capacity. • Minimum five (5) years of supervisory experience, managing diverse teams. • Experience managing and utilizing data to identify risks, trends, gaps, and opportunities. • Knowledge of MCO and/or PIHP delivery systems and current trends. • Experience with Medicaid populations, programs, and policies. • Excellent communication skills to include developing training materials, website postings, and newsletter outlines. • Experience in Quality Management and Performance Improvement methodologies. • Experience writing professional reports. • Experience with Utilization Management, Case Management, Managed Care networks, Claims/Appeals, and/or Population Health. • Knowledge of URAC and/or NCQA accreditation standards or certification a plus. • Excellent communication skills, both written and oral. • Experience making professional presentations to large audiences. • Ability to function independently and coordinate review activities. • Proficiency with Microsoft Office Products, including Word, PPT, Excel, etc. Benefits • Competitive salary and benefits package • Flexible, supportive hybrid work environment Apply tot his job