Director of Medical Management

Encino, California

Director of Medical Management Position Summary:    Are you an RN experienced with managing case managers in a managed care setting, looking for a new opportunity with a prestigious healthcare company as a Director of Medical Management? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes” to any of these questions – this is the position for you!

Hours for this Director of Medical Management Position:

Monday thru Friday 8am-5pm

Advantages of this Director of Medical Management Opportunity:

• Competitive salary, incentive bonus
• Fun and positive work environment
• Full Benefits

Required Skills

What We Look For in a Director of Medical Management:

• BSN with current RN license
• 3+ years of clinical experience- along with 3+ years in Case Management- (managing CM’s)- managed care setting (plus if certified CM)
• 3+ years in the delivery and oversight of medical management services
• 4+ years of Manager/Director experience
• 5+ years within health plan operations
• Proficient with Microsoft Office
• Excellent organizational and communication skills
• Experience w/California- Medicare/Medicaid

Responsibilities

More Insight of Daily Responsibilities of a Director of Medical Management: 

In this opportunity, you will:

• Leads Medical Management Department and assures consistency of operations across regional offices
• Leads development of medical management processes that are incorporated into the delivery of transactionally-based medical management services.
• Responsible for the following processes (but are not limited to):
  • Is responsible for the interpretation of data in relation to medical management decisions and quality

• Prior Authorization
• Case Management Services
• Utilization Management Services
• Concurrent Review
• Model of Care
• Quality Management
• Oversight of quality in relation to the delivery of medical management services
• Is the senior clinical person for the Medical Management function with Health Plan Operations
• Ensures qualified clinicians are accountable to the organization for decisions affecting client’s members
• Acts as a resource to account managers in relation to the delivery of medical management services and tools used by clients to review services provided
• Collaborates with the other departments

Want More Information on this Director of Medical Management?

Interested in hearing more about this great opportunity? Reach out to Laun at laun@healthcaresupport.com for immediate consideration.
Why You Should Work With Us:

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

DP14

Salary

$100K+