VP Medical Management Clinical Health Services Dir job in San Diego, CA| Recruit Arrow
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VP Medical Management Clinical Health Services Dir
Location : California, San Diego
Refer job # YBNC340257
Job Responsibilities and Requirements: Fundamental Components: Develop and manage clinical operations focused on improving clinical and financial outcomes, member engagement, and satisfaction. Serve as liaison with regulatory and accrediting agencies and other health business units. Formulate and implement strategy for achieving applicable department/unit metrics and provide operational direction. Serve as technical, professional and business resource (may cross multiple business functions). Develop and participate in presentations and consultations to existing and prospective customers. Direct/provide enhancements to business processes, policies and infrastructure to improve operational efficiency (may cross multiple business functions). Participates in internal and external health industry development efforts. Develop, implement, and evaluate policies and procedures, which meet business needs (may cross multiple business functions). Implement and monitor business plan and oversees any implementations or business transitions impacting service operations. Collaborate and partner with other business areas across/within regions or segments and within other centralized corporate areas to ensure all workflow processes and interdependencies are identified and addressed on an on-going basis. Promote a clear vision aligned with company values and direction; sets specific challenging and achievable objectives and action plans; motivates others to balance customer needs and business success; challenges self and others to look to the future to create quality products, services, and solutions. Background / Experience: Eight to Ten years of clinical leadership required. Seven to Ten years of managed care experience desired, and at least three years of experience required in California delegated model either with a health plan or IPA interfacing with external Medical Management partner(s) Master's degree in behavioral health field; or Registered Nurse (Masters preferred): and-Active unrestricted State Licensure in applicable functional area. (eg RN, LPC, LCSW) Ability to synthesize program performance and clinical outcomes. Demonstrated management experience selecting, motivating and leading teams; mentoring and coaching staff. Exceptional communication skills, verbal, written and presentation. Proficiency with MS Office Suite, applications. Education: The level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. Master's Degree preferred but not required. License and Certifications : Nursing/Registered Nurse (RN) and / or Mental Health / Licensed Clinical Social Worker. Functional Experiences: Functional - Medical Management/Medical Management - Administration/Management/7-10 Years Functional - Medical Management/Medical Management - Case Management/7-10 Years Functional - Medical Management/Medical Management - Concurrent Review/7-10 Years Functional - Clinical / Medical/Management: Technical - Desktop Tools/Microsoft Word/7-10 Years/End User Technical - Desktop Tools/TE Microsoft Excel/7-10 Years/End User Technical - Desktop Tools/Microsoft Outlook/7-10 Years/End User Technical - Desktop Tools/Microsoft SharePoint/1-3 Years/End User.
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