VP of Medical Management

(Job Id W318540)
Posted on 6/28/2010
Location:

Jackson, MS


Job Type:

Full Time


Salary: $120000.00 to $160000.00/year
Degree: Bachelor
Job Description
P of Medical Management

GREAT opportunity to build and develop your own team in a newly established location for expanding health plan. Direct and coordinate the medical management, quality improvement and credentialing functions for the assigned health plan based on, and in support of the companys strategic plan; establishing the strategic vision and attendant policies and procedures.

Position Responsibilities:

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.


Experience Required:

Our client is seeking a clinician who is very experienced in all aspects of medical management in a managed care organization to include CM, UM, QI, claims.....

Equivalent to a four (4) year education in nursing. Advanced education in nursing, health care, business or public administration preferred. Thorough knowledge of a specialized or technical field such as clinical nursing, managed care, and healthcare administration. Thorough skills knowledge of quality improvement practices. Familiarity of medical information systems, medical claims payment process, medical terminology and coding. Familiarity of case management practices, managed care, and Medicaid programs. Familiarity of National Committee on Quality Assurance (NCQA) accreditation process and standards

ABOUT THE COMPANY:
Our client is one of Americas premiere managed medicaid companies. Youll enjoy a comprehensive benefits program, very competitive salary and generous bonuses. FULL Relocation Package!!