UPMC Community Care Behavioral Health is hiring a full-time Quality Management Clinician to join the Quality team. This is a hybrid role that will work onsite at downtown Pittsburgh's US Steel Tower three days per week. This role will involve some local travel to providers within the Pittsburgh region.

The Quality Management Clinician is responsible for performing functions related to quality management and improvement, in compliance with NCQA, HEDIS, URAC and the Commonwealth of Pennsylvania Department of Health quality assurance regulations.

Responsibilities:

+ Responsible for performing targeted, clinical audits and focus studies.
+ Responsible for logging in, tracking, monitoring, and reporting individual and aggregate complaints and grievances to the Senior Director of Quality Management and other leadership staff members as appropriate. Prepares formal reports and tracks timing of various levels of complaint and grievance for further action.
+ Res...