Directs and oversees program operations in support of corporate and health plan management
Monitors national and local health plan market trends relative to the clinical span of the program
Leads and/or participates in cross-functional workgroups created to maintain and develop clinical programs
Evaluates all facets of the clinical program to improve efficiency of operations, financial return, customer service, and provider engagement
Develops, communicates, and monitors program schedule, budget, and resources plan; coordinates program deliverables and resolves issues that may hinder clinical program success
Hires, trains, coaches, counsels, and evaluates performance of direct reports
Requirements
Requires a BA/BS
minimum of 8 years experience in a related field
prior management experience
clinical, quality, and/or utilization management experience in a managed care setting
any combination of education and experience, which would provide an equivalent background
MBA preferred
RN, LSW, or LPN/LVN license preferred
Experience working with senior leadership and state stakeholders
Experience presenting reports to state stakeholders
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