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Sr Manager Clinical Business Solutions
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Albuquerque, New Mexico |
About this job
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability, or protected veteran status.
BASIC FUNCTION: This position is responsible for managing staff and project management coordination for divisional/enterprise Medical Management programs which includes developing, monitoring and evaluating medical management programs, care management strategies, and account management functions from the clinical perspective; administering and controlling the day to day operation activities; oversight or establishing cost-containment goals and objectives for projects; oversight or developing standard procedures to meet objectives; and representing the division with internal departments, external vendors and consultants.
JOB REQUIREMENTS: *Bachelor degree OR clinical licensure (RN, LMSW, LPC, RD, etc). *10 years experience in a managed care operations; such as Utilization Management, Case Management, Quality, and Product Development. *5 years management experience. *Extensive knowledge of medical terminology. *Familiar with state and federal accreditation requirements, policies and procedures for the states of Illinois, Texas, New Mexico or Oklahoma. *Experience in Managed Care programs and procedural development at the product level. *Project management experience including developing plans and driving results. *PC proficiency including Word, Excel, PowerPoint and databases. *Verbal and written communications skills including interpersonal, negotiation and presentation skills. *Ability and willingness to travel, including overnight stays.
**The position is located in Albuquerque**
RN Job Fair Thursday, September 10, 2015 2:00 PM -- 6:00 PM 5701 Balloon Fiesta Parkway NE Albuquerque, NM 87113
BASIC FUNCTION: This position is responsible for managing staff and project management coordination for divisional/enterprise Medical Management programs which includes developing, monitoring and evaluating medical management programs, care management strategies, and account management functions from the clinical perspective; administering and controlling the day to day operation activities; oversight or establishing cost-containment goals and objectives for projects; oversight or developing standard procedures to meet objectives; and representing the division with internal departments, external vendors and consultants.
JOB REQUIREMENTS: *Bachelor degree OR clinical licensure (RN, LMSW, LPC, RD, etc). *10 years experience in a managed care operations; such as Utilization Management, Case Management, Quality, and Product Development. *5 years management experience. *Extensive knowledge of medical terminology. *Familiar with state and federal accreditation requirements, policies and procedures for the states of Illinois, Texas, New Mexico or Oklahoma. *Experience in Managed Care programs and procedural development at the product level. *Project management experience including developing plans and driving results. *PC proficiency including Word, Excel, PowerPoint and databases. *Verbal and written communications skills including interpersonal, negotiation and presentation skills. *Ability and willingness to travel, including overnight stays.
**The position is located in Albuquerque**
RN Job Fair Thursday, September 10, 2015 2:00 PM -- 6:00 PM 5701 Balloon Fiesta Parkway NE Albuquerque, NM 87113
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