Vice President Medical Management permanent position at Troy MI
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Should someone need more information I can be reached at firstname.lastname@example.org or 203-567-0144.
Thank you for your time. Title: Vice President Medical ManagementLocation: Troy, MIType: Permanent Job Description:
Position Purpose: Perform duties to direct and coordinate the medical management, quality improvement and credentialing functions for the assigned health plan based on, and in support of the company’s strategic plan; establishing the strategic vision and attendant policies and procedures.
- Direct and coordinate activities of department and aid the chief officer of the health plan and appropriate corporate staff in formulating and administering organizational and departmental policies.
- Review analyses of activities, costs, operations and forecast data to determine department progress toward stated goals and objectives.
- Serve as a member of management committees on special studies.
- Administer and ensure compliance with National Committee on Quality Assurance (NCQA) and/or Joint Commission on Accreditation of Healthcare Organization (JACHO) standards as determined for accreditation of the health plan.
- Participate in, attend and plan/coordinate staff, departmental, committee, sub-committee, community, State and other activities, meetings and seminars.
- Participate in provider education and contracting, as necessary.
- Bachelor's degree in Nursing, related field or equivalent experience.
- 10+ years of clinical nursing, quality improvement, and management experience in a managed care setting.
- Knowledge of a specialized or technical field such as clinical nursing, managed care, and healthcare administration.
- Thorough skills knowledge of quality improvement practices.
- Working knowledge of medical information systems, medical claims payment process, medical terminology and coding, case management practices, managed care, and Medicaid programs.
- Familiarity of National Committee on Quality Assurance (NCQA) accreditation process and standards.
- Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
License/Certification: Current state nursing license.
Should someone need more information I can be reached at