Case Management and Medical Expense Performance Vice President

Job Summary

A company is looking for a Vice President of Case Management and Medical Expense Performance.

Key Responsibilities:

• Develop, implement, and lead Case Management and Medical Expense Performance management programs across all markets and products
• Lead the development of solutions and approaches to ensure quality and consistency of clinical programs and services
• Collaborate with clinical and operational teams to identify and implement waste reduction initiatives

Required Qualifications:

• Licensed Registered Nurse or equivalent with active licensure
• Bachelor's Degree in healthcare or business required, Master's degree strongly preferred
• 10+ years healthcare experience, including 5 years in case management and medical expense management
• 5+ years program development and implementation experience
• Working knowledge and experience with healthcare financing models such as Medicare, Medicaid, SNP, PACE strongly preferred