Clinical Assistant Vice President
Posted on Nov 21, 2018 by Beacon Health Options
Executive / Administrative Level
We are currently seeking a dynamic Clinical Assistant Vice President to join our team at our office in Newark, NJ!
ABOUT THE POSITION
We are currently seeking a dynamic Clinical Assistant Vice President to join our team at our office in Newark, NJ! The AVP is responsible for clinical oversight of utilization management and case management activities throughout the service center's multi-state offices/engagement centers and contracts. The primary focus of this position is to ensure that the delivery of quality clinical care and service to health plan members meets NCQA, URAC, and state, federal and contractual requirements. The AVP works in collaboration with the other service center operational units to ensure the clinical operational needs of the organization are met. Regional Clinical directors will report into the AVP.
- Clinical oversight of all utilization management, case management and disease management operations across the service center multi-state offices/engagement centers and contracts.
- Oversight of the development of and adherence with organizational and state specific UM, CM and DM policies and procedures.
- In collaboration with Clinical Directors monitors the census across all contracts and provides monthly updates to VP of Operations.
- Provides direction to the Regional Directors on program metric development, analysis and benchmark adoption.
- Provides direction to plan Clinical Directors in the reporting and analysis of plan specific UM and CM metrics.
- In collaboration with the VP of Operations monitors utilization and case management trends and formulates strategies to manage costs.
- Directs UM and CM programs in the development of clinical programming to improve the health outcomes of the members we serve.
- Represents Beacon at client meetings regarding clinical issues.
- Resource to the Director of Quality Management and Improvement on all NCQA and URAC initiatives and readiness.
- Periodic consultation with practitioners in the field through attendance at site visits, professional meetings and conferences as well as through membership on various committees, i.e. Provider Advisory, Clinical Management, etc. to which practitioners are invited.
- Participates and consults on corporate initiatives and activities as a subject matter expert.
- Collaborates with other service centers to promote best practices.
- Other duties as assigned.
Education: Master's Degree
Licensure: NJ Independent LCSW Licensure
Relevant Work Experience: A minimum of 8 years' of managed care experience, in both the public sector and commercial lines of business
Knowledge, Skills & Abilities: Expert and proficient level of knowledge, skill and ability
- Analytical and problem solving ability
- Interpersonal communication skills
- Verbal and written communication skills
- Group presentation and public speaking skills
- Collaboration and team-oriented work philosophy
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Beacon Health Strategies, LLC. a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled
AAP Reporting Location:
NJ - Roseland
ID (Req #):
Mon - Fri 40hours
Worldwide Flight Services/WFS