VP Health Services (RN) | Medical Management
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...VP Health Services | Medical Management (RN) - KANSAS
Exceptional analytic support – unlimited career growth
.....Reporting to the CEO, experienced clinical leader will establish the strategic vision and drive initiatives around programs of care management and quality. Collaborative participation with the exceptional leadership team in this market is a strong platform for success.
Established business and new product are rolling out in KS.
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.
Participate in, attend and plan/coordinate staff, departmental, committee, sub-committee, community, State and other activities, meetings and seminars.
Engage with providers in education and contracting initiatives.
-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.
Thorough 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 of 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.
License/Certification: Current state nursing license - prefer KS
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