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Operations Manager Quality Management

Date:  Apr 15, 2021
Brand:  EyeMed Vision Care
Location: 

Mason, OH, US, 45040

Requisition ID: 335543 
Position:Full-Time
Total Rewards: Benefits/Incentive Information

 

There’s more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the country with consistent double-digit membership growth! Through our commitment to innovation, we’re reimagining the way employers and their employees think about vision care. We want them to see life to the fullest and experience more of what’s best, not more of the same.  And if what’s best hasn’t been done yet, it’s our exceptional and passionate employees driving this change. But, our passion for vision isn’t just about vision insurance benefits. Our employees are proud to support and participate in life-altering global and local missions through our partnership with OneSight, a leading not-for-profit organization with a 100% focus on eradicating the world’s vision crisis.

 

Your family says a lot about who you are. EyeMed is a key member of the Luxottica family of companies, global leaders in the design, manufacture and distribution of fashion, luxury and sports eyewear.  In North America, Luxottica is the home to global brands Ray-Ban, Oakley and many top fashion house brands.  Our leading retail brands include LensCrafters, Sunglass Hut, Pearle Vision, Target Optical and Sears Optical.

 

If you’re passionate about driving innovation and change and interested in a career in the optical and insurance industry, EyeMed wants to start the conversation and help provide you a growth-focused opportunity with America’s fastest growing vision benefits company.

GENERAL FUNCTION

The Manager-Quality Management is responsible for leading, implementing, and monitoring Quality Work Plan initiatives and driving process improvement that will enhance the experience of members and providers in their interactions with EyeMed and MESVision. This role oversees internal and external audits, the virtual provider audit process, the patient record review process, and quarterly meetings of the Quality Committees and Public Policy Committees. This role monitors and reports KPIs and assures planned deliverables for quality improvement projects are met.

 

MAJOR DUTIES AND RESPONSIBILITIES

  • Oversees the compilation of data and reports for quarterly meetings. Manages the Annual Quality Work Plan and recommendations made by the Quality Improvement Committee (QIC), Quality Management Committee (QMC), and Public Policy Committee (PPC) in collaboration with the cross functional business teams
  • Partners with leadership and Clinical Director in the operational execution of the Quality Management Program
  • Performs on-going analysis of key quality indicators to clearly document current state, identify gaps, provide recommendations and lead quality improvement initiatives
  • Acts as the department quality monitoring advocate to drive change across EyeMed’s vision care delivery system
  • Manages projects by meeting established team deliverables/timelines and works with leadership to align on prioritization of projects for the Provider Relations team
  • Partners with operations teams to align solutions with process enhancements ensuring streamlined business processes that maintain quality standards
  • Aligns project scope and deliverables with federal and state regulations, NCQA Standards, and healthcare partner requirements
  • Partners with the functional compliance manager to ensure new processes are established and compliant with federal/state regulations and monitors for continued adherence
  • Partners internally to develop and enhance communications and training materials for providers and members, complying with all marketing collateral to deliver the Provider core story
  • Facilitates ongoing outreach to ensure provider and member satisfaction and identifies issues before escalation. Works with cross-functional managers to address administrative concerns or issues and to resolve escalated quality issues
  • Identifies opportunities and makes recommendations for process improvement necessary to facilitate member and provider satisfaction

 

BASIC QUALIFICATIONS

  • Bachelor's Degree or equivalent
  • 5+ years of health plan or vision plan experience
  • Excellent interpersonal, oral and written communication
  • Strong problem-solving, analysis and issue resolution skills
  • Proven ability to effectively manage multiple projects simultaneously, set priorities, identify/address problems and meet deadlines
  • Ability to influence others and align stakeholders on issues of significant importance to the organization
  • Working knowledge of standards and requirements of NCQA, CMS, and HHS.
  • Knowledge and expertise in business analysis, process improvement, and project management
  • Proficient in Microsoft Office Products and ability to learn department and job specific software systems

 

PREFERRED QUALIFICATIONS

  • Master’s Degree
  • Experience in health care quality improvement
  • NCQA and Regulatory audit experience
  • SAP Business Objects reporting experience

Upon request and consistent with applicable laws, Luxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process.  To request a reasonable accommodation, please call the Luxottica Ethics Compliance Hotline at 1-888-887-3348 or e-mail HRCompliance@luxotticaretail.com (be sure to provide your name and contact information for either option so that we may follow up in a timely manner). 

We are an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, color, gender, national origin, social origin, social condition, being perceived as a victim of domestic violence, sexual aggression or stalking, religion, age, disability, sexual orientation, gender identity or expression, citizenship, ancestry, veteran or military status, marital status, pregnancy (including unlawful discrimination on the basis of a legally protected pregnancy or maternity leave), genetic information or any other characteristics protected by law.  Native Americans receive preference in accordance with Tribal Law.


Nearest Major Market: Cincinnati

Job Segment: Operations Manager, Marketing Manager, Manager, Business Process, Operations, Marketing, Management

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