South Carolina Licensed Program Lead

Job Summary

A company is looking for a Cost Containment and MLR Optimization Program Lead.

Key Responsibilities

• Develop, implement, evaluate, and maintain health management programs
• Conduct health management presentations tailored to meet health plan and customer needs
• Establish reporting mechanisms for clinical outcomes, utilization statistics, and ROI

Required Qualifications, Training, and Education

• Bachelor's degree in a job-related field or equivalent nursing degree
• 5 years of clinical experience or experience in developing population health programs, with 2 years in a supervisory role
• Active, unrestricted RN licensure or equivalent for Social Worker/Counselor
• Working knowledge of Microsoft Office and relevant software
• Ability to understand and communicate healthcare policy