Vice President of Medical Management

Vice President of Medical Management needed!

Up to $185,000

Rochester Hills MI

You will administer and ensure compliance with National Committee on Quality Assurance (NCQA) and/or Joint Commission on JACHO standards as determined for accreditation of the health plan. You will direct and coordinate activities of department and assist the executive officer of the health plan and appropriate corporate staff in formulating and administering organizational and departmental policies. You will review analyses of activities, costs, operations and forecast data to determine department progress toward stated goals and objectives. In addition, you will participate in, attend and plan/coordinate staff, departmental, committee, sub-committee, community, State and other activities, meetings and seminars.


You must have 10+ years of clinical nursing, quality improvement, and management experience in a Managed Care setting.
You will need Bachelor's degree in Nursing, related field or equivalent experience, MS's is a plus!
Must have skills knowledge of quality improvement practices as well as working knowledge of medical information systems, medical claims payment process, medical terminology and coding, case management practices, managed care, and Medicaid programs.
Must be 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.
Active Nursing license for state of MI

This is a new position open due to growth reporting to the Plan President. Local is preferred but there is relocation provided! Only if you fit the above the requirements are you encouraged to apply for this position. Please send all resumes to: Paul :)



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