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Vice President Medical Management | RN

Baton Rouge, LA

Vice President Medical Management | RN

Job Description

VP, Health Services | Medical Management - Baton Rouge

VP will be a part of strong & collaborative leadership team with the opportunity to be a key strategist in this market. 

Incredible growth opportunities and perks for this executive role 

GENEROUS relocation & competitive compensation. 

** We are seeking an experienced leader with a proven background in an MCO/health plan/ACO. 

Direct and coordinate the medical management, quality improvement and credentialing functions for the for the LA 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. 

 

Job Requirements

Qualifications:

  • Bachelor's degree in Nursing, related field or equivalent experience. 
  • 10+ years of clinical nursing, quality improvement, and management experience 
  • Leadership 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. 
  • Current RN license REQUIRED.

About MMS Group

MMS is a Managed Care executive search firm. We are Managed Care's complete recruiting resource.

Keywords: rn jobs near me, nurse executive role, nurse jobs near me, managed care jobs, leadership jobs in healthcare, nursing leadership and management jobs, healthcare jobs in baton rouge, anthem careers, united health careers, nurse executive jobs

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