MIT RESOURCE
Vice President Medical Management permanent position at Troy MI
MIT RESOURCE, Troy, Michigan, United States, 48083
Vice President Medical Management permanent position at Troy MI
Full-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 Qualifications:
• 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 with 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.
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Full-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 Qualifications:
• 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 with 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.
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