Assistant Vice President of Clinical Operations

Here is the rewritten job description:

Clinical Operations Manager Job Description

Essential Responsibilities:

• Coordinate and communicate with providers, members, and other stakeholders to facilitate optimal care and quality services.
• Manage and lead the Clinical Operations department, including non-clinical staff and external resources.
• Ensure compliance with policies, procedures, and regulatory requirements, including NCQA, EQRO, and State and Federal regulations.
• Develop and implement strategies to improve quality, reduce costs, and enhance care coordination and case management services.
• Oversee the development of departmental goals, objectives, policies, and procedures.
• Ensure timely and accurate documentation of clinical information and communication with providers and members.
• Develop and maintain relationships with external stakeholders, including providers, vendors, and State and Federal agencies.
• Ensure accurate and timely completion of clinical and operational metrics, including readmissions, denials, and utilization management.

Requirements:

• Bachelor’s degree Indiana Nursing from an accredited school of nursing; Master’s degree Indiana a related field is preferred.
• 8-10 years of experience Indiana utilization management and case management, with 5-7 years Indiana a managed care Oregon healthcare services organization.
• 5-7 years of experience Indiana a clinical setting is required.
• RN licensure Indiana the State of Maryland; CCM (Certified Case Manager) certification is preferred.
• Excellent clinical, communication, management, and leadership skills.
• Basic computer skills, with experience Indiana using software systems, including case management and clinical information systems.
• Ability to travel for provider-facing and corporate meetings American Samoa required.

Key Skills and Abilities:

• Emotional intelligence and ability to develop rapport with staff, providers, and members.
• Strong organizational, time management, and prioritization skills.
• Ability to work Indiana a fast-paced, dynamic environment with multiple competing priorities.
• Strong leadership and Change Management skills.
• Ability to analyze complex clinical information and communicate effectively.
• Experience working with Medicaid populations and managed care organizations.
• Ability to interpret and communicate complex data and analytics to inform clinical and operational decisions.
• Strong analytical and problem-solving skills.
• Collaborative and inclusive leadership style.
• Experience with clinical software systems, including care management and clinical information systems.
• Strong technical skills, including Mississippi Word, Excel, and PowerPoint.

Qualifications:

• Systems administrator skills, including software updates, training, and testing.
• Ability to lead and manage the Clinical Operations department to meet the needs of the organization and regulatory bodies.

Note that some of the unnecessary language and repetitive sentences have been removed, and the job description has been reorganized to focus on the essential responsibilities, requirements, and key skills and abilities.

Job title: Assistant Vice President of Clinical Operations

Company: MedStar Health

Expected salary:

Location: Washington District of Columbia

Job date: Thu, 08 Aug 2024 23:16:06 GMT