Director Market Clinical Population Health, RN/LMSW
Company: Amerihealth
Location: Washington
Posted on: March 20, 2023
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Job Description:
Job Description:
\nJob Brief\n Ability to work a hybrid schedule out of our DC
campus is required.\n\n\n\n\n\n Your career starts now. We're
looking for the next generation of health care leaders.\n At
AmeriHealth Caritas, we're passionate about helping people get
care, stay well and build healthy communities. As one of the
nation's leaders in health care solutions, we offer our associates
the opportunity to impact the lives of millions of people through
our national footprint of products, services and award-winning
programs. AmeriHealth Caritas is seeking talented, passionate
individuals to join our team. Together we can build healthier
communities. If you want to make a difference, we'd like to hear
from you.\n Headquartered in Philadelphia, AmeriHealth Caritas is a
mission-driven organization with more than 30 years of experience.
We deliver comprehensive, outcomes-driven care to those who need it
most. We offer integrated managed care products, pharmaceutical
benefit management and specialty pharmacy services, behavioral
health services, and other administrative services. Discover more
about us at www.amerihealthcaritas.com.\n\n\n\n\n\n\n
Responsibilities:\n The Market Clinical Director, Population Health
is responsible for market specific clinical operations supervising
all UM, ICM, and RROT staff and ensuring all market activities
conform to enterprise program descriptions, policies and
procedures.\n Oversight of execution of market specific clinical
programs including UM, CM, RROT, and Bright Start.\n Assures
compliance of program execution with enterprise policies.\n
Monitors performance metrics across multiple LOBs and assures that
appropriate action is taken to address performance opportunities
consistent with enterprise policies.\n Responsible for market
specific contract and accreditation compliance related to
Population Health Clinical Operations.\n Supervises market specific
Population Health Clinical Operations staff.\n
Education/Experience:\n\nBachelor's degree required in Nursing or
healthcare related field / Master's preferred or equivalent work
related experience.\nClinical license in the District of Columbia
is required, RN is preferred.\nLCSW or BH equivalent advanced
licensure can be considered.\nCCM certification preferred /
required within 2 years of hire.\n3-5 years progressive management
experience (including staff management) in a managed care
environment. \n3-5 years experience with Managed Medicaid clinical
programs highly desirable. \n3-5 years management experience with
Case Management and Utilization management programs preferred.
\n3-5 years experience in CM and UM program design, implementation
preferred. Should include experience in setting, communicating and
implementing strategic direction.\n
\n\n\nBack\n\n\n\n\n\n\n\n\nApply Now\n\n
Keywords: Amerihealth, Washington DC , Director Market Clinical Population Health, RN/LMSW, Healthcare , Washington, DC
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