Ensures appropriate members are included in the PCM for optimum care delivery. Coordinates with VP Health Promotion and Outreach to deploy resources in the field to achieve preventive health goals. Possesses a global understanding of the Health Services department and coordinates services as necessary. Master's degree in health related field preferred. Must have 8-10 years managed care and supervisory experience with strong clinical management background in a wide range of service areas.
Problem solving and decision-making skills are critical.
Travel is required as needed. The selected candidate will have prior management experience, preferably in a managed care environment with direct oversight of pre-certification. Consideration will be given to candidates with experience overseeing a nurse triage team or experience managing clinical personnel. Knowledge and skills managing a call center is a plus. Must be a licensed RN in NY or NJ, detail oriented, and possess excellent communication skills.