Job Summary

Description:

If you are a Registered Nurse with clinical and leadership experience, take a look at this opportunity. We are offering a Director level position to the qualified candidate capable of providing leadership and guidance for case management, care coordination and utilization management services provided to health plan members. The Medical Manager, Director manages the activities of staff, creates clinical programs to meet the needs of members and provides advice and information to higher level management related to medical management.

This is a full-time position with a large reputable managed health plan. The Director position reports to the Vice President of Medical Management. US Citizenship and government clearance is required. Potential for some intermittent telecommute.

Job Requirements:

Effectively manages the activities of staff providing leadership and guidance.

Identifies department goals and objectives, communicates action plans and sets clear objectives.

Identifies training needs and staff development needs.

Develops monitoring systems and measurements for peak customer service.

Plans and develops performance improvements for the control of quality and reliability.

Organizes and promotes quality management functions.

Manages statistical and qualitative information concerning patient outcomes and physician / hospital practice patterns, in accordance with health plan standards.

Qualification:
Master's degree in health services administration or equivalent.
Bachelor's degree in, nursing or other health related field.
Five years experience in a clinical setting.
Five years management experience.
Three years utilization management background.
Four years in quality management / quality improvement in a health care setting.




Client Company Benefits:*

Health, Vision & Dental insurance

Flexible spending accounts

Short- and long-term disability insurance

Basic Life insurance

Supplemental Life/AD&D

401(k) retirement plan

Paid-Time-Off to include: Vacation, Personal and Sick time & Company Holidays

Employee Assistance Program (EAP)

Tuition Reimbursement/Educational Assistance



*Upon meeting company & plan eligibility requirements


Licensure
Current and unrestricted RN license

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