Senior Vice President, Medical Management

SUN Information Systems Inc.

Posted Under: Chicago, Illinois jobs in Executive; Executive jobs in zipcode 60601
Posted On: 2017-11-23 05:00:00

Job DescriptionVice President, Medical ManagementJob description10+ years of clinical nursing, quality improvement, and management experience in a managed care setting.Thorough knowledge of a specialized or technical field such as clinical nursing, managed care, and healthcare administration.Reporting to the Plan President, the VP Medical Management will perform duties to direct and coordinate the medical management, quality improvement and credentialing functions for the assigned health plan based on, and in support of the company’s strategic plan; establishing the strategic vision and attendant policies and procedures.Direct and coordinate activities of department and aid the chief officer of the health plan and appropriate corporate staff in formulating and administering organizational and departmental policies.-Review analyses of activities, costs, operations and forecast data to determine department progress toward stated goals and objectives.-Serve as a member of management committees on special studies.-Administer and ensure compliance with National Committee on Quality Assurance (NCQA) and/or Joint -Commission on Accreditation of Healthcare Organization (JACHO) standards as determined for accreditation of the health plan.-Participate in, attend and plan/coordinate staff, departmental, committee, sub-committee, community, State and other activities, meetings, and seminars.-Participate in provider education and contracting, as necessary.Qualifications:Education/Experience:Bachelor's degree in Nursing-Thorough skills knowledge of quality improvement practices.-Working knowledge of medical information systems, medical claims payment process, medical terminology, and coding, case management practices, managed care, and Medicaid programs.-Care coordination improvement/enhancement-Familiarity with National Committee on Quality Assurance (NCQA) accreditation process and standards.-Previous management experience including responsibilities for hiring, training, assigning work and managing the performance of staff.-License/Certification: Current state nursing license.*Plus 30% bonus + EquityView (copy) link below to match your resume to this job. Increase your chances of interview and landing this position: DescriptionSUN Information Systems Inc., is a Managed Project Solutions, Consulting Services, Talent Acquisition, Staff Augmentation,to clients across the United States and Europe.SUN Information Systems Inc., is in the business of supporting organizations to operate more productively and profitably through a full spectrum of development, specialized products, solutions, project implementation and other technology services. We specialize in the areas of application development, support, system architecture, design & administration, system integration, data mining, cyber security and performance tuning for vertical markets including Information Technology, Healthcare, and Financial Services. SISI has been providing superior information technology talent and solutions to our customers. Our reputation as an IT expert is built on a decade of experience as a full-spectrum source for the IT community and Healthcare Community. Our current customer roster features Fortune 500 companies and several top vendor companies, who in-turn serves multiple clients.