MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus’ network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
The Quality Control (QC) Manager of MLTC is responsible for supporting the day-to-day functions of the MLTC Plan. He/she will manage MLTC’s quality control & quality improvement activities and initiatives, including overseeing the MLTC Quality Analyst. He/she will analyze performance and recommend improvement initiatives and/or corrective actions strategies. The QC Manager will oversee the quality of assessments, care plans and the care planning processes. The Quality Control Manager will be responsible for developing, implementing, and evaluating MetroPlus’ MLTC performance improvement activities including, but not limited to, analyzing data to identify performance trends; prioritizing and recommending improvements and coaching staff to achieve better performance. The QC Manager will play a role in ensuring compliance with all State and Federal contractual requirements regarding quality management.
The QC Manager will anticipate and resolve complex issues and ensure accurate and quality record keeping. The QC Manager will work closely with the Medical Management Quality Management department as well to ensure that QM staff have access to the MLTC records and information they need. In addition to the day-to-day responsibilities, the Quality Control Manager will work in conjunction with the Director of MLTC-PCS on a variety of critical tasks.