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Vice President Medical Management permanent position at Troy MI

Company: MIT RESOURCE
Location: Troy
Posted on: November 1, 2024

Job Description:

Vice President Medical Management permanent position at Troy MI


  • Full-time

    Title: Vice President Medical Management
    Location: Troy, MI
    Type: Permanent
    Job Description:
    Position Purpose: Perform duties to direct and coordinate the medical management, quality improvement and credentialing functions for the assigned health plan based on, and in support of the company's strategic plan; establishing the strategic vision and attendant policies and procedures.
    --- 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.
    --- Participate in provider education and contracting, as necessary.
    Required 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.
    --- 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 with 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.
    #J-18808-Ljbffr

Keywords: MIT RESOURCE, Detroit , Vice President Medical Management permanent position at Troy MI, Executive , Troy, Michigan

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