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VP, Health Services - Medical Management

Company: Cameron Craig Group
Location: Columbia
Posted on: July 13, 2019

Job Description:


-- VP Medical Management - Health Services -----South Carolina
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VP will be a part of strong & collaborative leadership team with the opportunity to be a key strategist in this market.
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-------- Incredible growth opportunities and perks for this executive role
------------------------------ GENEROUS relocation & competitive compensation.
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--** We are seeking an experienced leader with a proven background in--an MCO/health plan/ACO.--
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Direct and coordinate the medical management, quality improvement and credentialing functions for the--SC market,-- establishing the strategic vision and policies and procedures for the entire medical management team.
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-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.
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-Review analyses of activities, costs, operations and forecast data to determine department progress toward stated goals and objectives.
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- Serve as a member of management committees on special studies.
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-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.
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----Participate in, attend and plan/coordinate staff, departmental, committee, sub-committee, community, State and other activities, meetings and seminars.
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-Participate in provider education and contracting, as necessary.
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Qualifications:- 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.
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-Familiarity of National Committee on Quality Assurance (NCQA) accreditation process and standards.
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-Strong Leadership skills with succession planning experience.
Ability to lead both in person and remote direct reports.
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-Current-- nursing license REQUIRED.

Keywords: Cameron Craig Group, Columbia , VP, Health Services - Medical Management, Executive , Columbia, South Carolina

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