Healthcare Services Director
Where
- Charleston, SC
What you'll be doing
- Responsible for meeting annual healthcare cost and quality targets for the plan and achieving/retaining NCQA excellent rating. Works with the healthcare services management team to achieve the successful implementation of clinical strategy and direction. Mentors, guides and develops skills of management team members in a consistent and effective manner. Abandons initiatives and programs that do not produce significant quantifiable results and concentrate on driving those that do. Provides oversight support and direction to the utilization management, health integration and pharmacy operations teams and assists staff to analyze, update and modify policies, standard operating procedures and processes to continually improve utilization management operations and carry out clinical strategy. Accountable for insuring compliance with contractual, accreditation and regulatory requirements for all healthcare services teams. Responsible for developing the healthcare services department budget and meeting budget targets, both administrative and healthcare costs. Provides overall support and direction to the director, health integration toward the development and implementation of patient centered healthcare homes at all direct delivery primary care clinics in markets where they exist. Supports and supervises the director, health integration and drives integration of behavioral and physical health components in all aspects of service to members and develops long term care expertise needed in order to effectively manage vulnerable populations.
What your background should be
- Minimum seven years managed care experience with line management responsibility including clinical operations. Work within applicable state, federal, and third party regulations. Meet quality accreditation standards (NCQA/HEDIS). Familiarity and experience in the local market desirable (preferred). Strong communication and teaming/interpersonal skills. Strong leadership capabilities, and ability to initiate and maintain cross-team relationships. Strong interpersonal skills.
Required Schooling / Training
- BA/BS in business or related field. Master degree in business or healthcare management (i.e. MBA, MHA, MPH) preferred.
Who is the client company
- This is a managed care company serving people through government-based healthcare programs.
- If you are interested in this position, send your resume to apply@kochdavis.com
