Vice President of Medical Management (JO# 23191)
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General Summary:
- The Vice President of Medical Management leads and manages the day-to-day operations of utilization, clinical resource and case management departments and focuses on the continuum of care for the patient population.
- Develops medical management programs that allows the hospital(s) to meet clinical resource management goals as well as third party and regulatory standards.
- Manages and educates staff at all levels about effective clinical resource management. Provides formal and informal programs.
Experience:
- At least 3+ years Nursing Management experience in an acute care setting required
- Hospital Case Management experience required
- Managed Care Organization (MCO) experience preferred
Education:
- Bachelor of Science in Nursing (BSN) required
- Master’s Degree in Nursing or a related healthcare field preferred
Certifications/Licensures:
- Registered Nurse License required
- Certified Case Manager (CCM) a plus, not required
- Healthcare Quality of Utilization Review (HQUR) a plus, not required
Special Skills:
- Advanced communication and interpersonal skills
- Analytical and quantitative analysis skills
- Ability to lead a complex department to reach and exceed goals
- Ability to work with other departments
- Knowledge of Managed care trends, Medicare and Medicaid regulations
