VP, Medical Management | Health Services (RN) - Indianapolis
.....Innovative healthcare enterprise needs a strategic RN who excels in a value-based environment where collaboration with providers is promoted and embraced.
Indy is such a comfortable, affordable Midwestern city; easily commutable with so many indoor and outdoor activities, pro football, theater, and extensive opportunity for culinary adventures!
- GENEROUS relocation- great benefits and perks
VP will direct and coordinate the medical management, quality improvement and credentialing functions.
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 NCQA and Joint Commission 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.
- Bachelor's degree in Nursing, related field or equivalent experience.
-10+ years of experience encompassing clinical nursing, quality improvement, and management experience.
- Must have previous experience in a health plan/MCO/ACO
Working knowledge of medical information systems, medical claims payment process, medical terminology and coding, case management practices, managed care, and Medicaid programs.
Familiarity of NCQA accreditation process and standards.
Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
License/Certification: Current IN RN License - or willing to obtain