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Job Details

Vice President Medical Management

Company name
Centene Corporation

Rego Park, NY, United States

Employment Type

Clevel, Executive, Healthcare, Nursing, 100k

Posted on
Aug 03, 2020

Valid Through
Nov 16, 2020

Apply for this job


Vice President, Medical Management','1192186','!*!Position Purpose: Perform duties to direct and coordinate the medical management, quality improvement and credentialing functions for the assigned health plan based on, and in support of the company’s strategic plan; establishing the strategic vision and attendant policies and procedures.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 QualityAssurance (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. ','!*!Education/Experience: 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. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff. License/Certification: Current state nursing license.PA Plan Only: State license required within 90 days of hire.Fidelis Care Plan Only: Bachelor’s degree in healthcare administration or related field required; master’s degree preferred.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.','Clinical & Nursing','USA-New York-Rego Park','USA-New York-Getzville','Fidelis Care','Full-time','','false','Vice President, Medical Management

Company info

Centene Corporation
Website :

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