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Maganti IT Resources LLC

maganti it resource,5meadow street naugatuck
naugatuck, CT, United States

Phone: 2035670144
Web Site: www.mitresource.com

Company Profile


Vice President Medical Management permanent position at Troy MI


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Job ID:

9702

Location:

Troy, MI, United States 

Category:

Management

Salary:

per year
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Job Views:

163

Zip Code:

48007

Employment Type:

Full time

Posted:

03.12.2015
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Job Description:

Vice President Medical Management permanent position at Troy MI
 
Dear Mr
 
Please help pass along to colleagues or associates below position who are looking for new role, If you are not available.
Should someone need more information I can be reached at sai@mitresource.com or 203-567-0144.
 
Thank you for your time.
 
Title: Vice President Medical Management
Location: Troy, MI
Type: 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.
Required Qualification:
  • 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
  • or 203-567-0144.
 
 


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