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VP Medical Management | Health Services

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Sunrise, FL
Job Type
Direct Hire
Nov 12, 2018
Job ID
VP Medical Management | Health Services -  Ft Lauderdale, FL

VP will be a part of strong & collaborative leadership team with daily interaction with C - Suite executives.

     Incredible growth opportunities and perks for this executive role
                GENEROUS relocation & competitive compensation.

Direct and coordinate the medical management, quality improvement and credentialing functions for the for the Florida market,  establishing the strategic vision and policies and procedures for the entire medical management team.

-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.

- 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.

-Familiarity of National Committee on Quality Assurance (NCQA) accreditation process and standards.

-Strong Leadership skills with succession planning experience.
Ability to lead both in person and remote direct reports. Experience with a large staff and a large numbers of lives/members.

-Current  nursing license REQUIRED.