VP Medical Management | RN
Job Title: VP Medical Management | RN
Employer: MMS Group
Location: Little Rock, Arkansas
Job Type: Full-Time
Career Level: Experienced
Experience: 10-15 years
Education Level: Bachelors Degree
Amazing opportunity to be a clinical strategist for this health plan in a market with a very strong growth trajectory.
Implement new programs and products, create a cohesive culture, collaborate closely with Quality and Provider Engagement teams. International healthcare enterprise is a solutions and thought leader in this market.
GENEROUS relocation- incredible tools & technology
We need a business – savvy clinician with a strong drive to improve health outcomes and quality of care for the vulnerable populations. Make your mark and accelerate your career! Experienced leader should bring a proven background in an MCO/health plan/ACO. Experience with special needs and behavioral health is a plus.
VP will shape and direct the medical management department and initiatives. Directors reporting to the VP will have oversight for day to day activity of the CM, UM and DM teams.
-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.
- Bachelor’s degree in Nursing, related field or equivalent experience.
- 10+ years of clinical nursing, quality improvement, and management experience
- Leadership experience in a managed care setting.
- 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 of National Committee on Quality Assurance (NCQA) accreditation process and standards.
- Current nursing license REQUIRED.
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About MMS Group:
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