VP of Medical Management | Health Services - (RN) - Milwaukee, WI
Milwaukee... on the shores of Lake Michigan...you will find it is a very comfortable place to enjoy life...rich in historical and cultural attractions, and the perfect place for exploring the outdoors.
Company offers generous relocation & perks, including TUITION & stock options
Join an already successful leadership team as they continue to improve outcomes and quality in WI. VP will establish and implement the strategic vision for all medical management and quality functions.
This is an IDEAL opportunity to bring your innovative ideas and success stories to an organization that values and listens to their clinical leadership. Exceptional analytic support and financial resources to bolster your opportunity for success.
- Review and analyze all activities, costs, operations and forecast data to determine department progress.
- Participate with executive committees on special studies.
- Administer and ensure compliance with NCQA standards.
- Participate in staff, departmental, committee, sub-committee, community, State and other activities, meetings and seminars.
- Be involved with provider education and contracting activity as appropriate.
Successful candidate will have Bachelor's degree in nursing, or equivalent experience.
10+ years of clinical nursing, quality improvement, and management experience in an MCO | health plan setting.
Thorough skills & knowledge of quality improvement practices.
Familiarity of medical information systems, medical claims payment process, medical terminology and coding.
Familiarity of case management practices, managed care, and Medicaid programs.
Familiarity with NCQA accreditation process and standards