Vice President Medical Management permanent position at Troy MI - MIT Resource : Job Details
Vice President Medical Management permanent position at Troy MI
MIT ResourceJob Location : Troy,MI, USA
Posted on :
2024-12-18T23:59:13Z
Job Description :
Vice President Medical Management permanent position at Troy MI
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- Full-time Title: Vice President Medical Management Location: Troy, MI Type: Permanent Job Description: PositionPurpose: 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
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