Compass Healthcare Consulting & Placement is conducting a search for an AVP of Care Management, a Registered Nurse, for our Client a Managed Care Organization located on the border of Nassau County and Queens, NY. Company Offers onsite parking in a beautiful setting. This is an opportunity to support rapid growth and quality working with a team of Directors and experienced leaders in the Managed Care setting.
Ideal candidate will be an experienced AVP level RN for a Managed Care Plan, with experience in Managed Long Term Care Plans and/or Medicare Advantage Plans, emphasis on Care/Case Management needed. Assistant Vice President
RN - AVP of Care Management - Registered Nurse
The AVP of Care Management is responsible for providing oversight and broad direction and strategic planning to Care Management, which includes care planning, coordination, utilization management. The RN - AVP of Care Management works closely with clinical consultants, staff and Managed Care Plan (MLTC) leadership while providing synergy with operational leaders by developing ongoing strategies to assure high quality care management outcomes. The AVP of Care Management expedites the member's progression along the continuum of care to attain timely and appropriate access to services, and to ensure the appropriate level of care is provided to all member populations enrolled in Managed Care Plan (MLTC).
ESSENTIAL JOB DUTIES
- Manages the Care Management Program, including the functions of Care Management, utilization management, and ensures effective care planning
- Ensures all care management policies and procedures are being consistently applied within the department.
- Establishes guidelines for safe and appropriate care planning as well as utilization management practices that meet all Managed Care Plan(MLTC), state and regulatory requirements.
- Oversees the quality of care/services rendered, ensuring efficient management of assignments, competency and educational needs of the Care Management staff and effectively coordinates and controls resources.
- Oversees the day-to-day and after hour on-call operations of the care management department, Provides backup support for after-hour on-call coverage.
- Facilitates care management activities by addressing policy and program level issues that are identified.
- Perform other duties and responsibilities as necessary
- Licensed & Registered RN in the State of New York
- Bachelor's degree in Nursing, Master's degree in healthcare, business, or healthcare preferred.
- 3-5 years in a Care Management and Managed Long Term Care setting.
- Certification in Care Management and/or Utilization Management, Medicare Advantage Plan and/or Managed Long Term Care Plan (MLTC) Experience Required.
- Strong organizational and communication skills required.
- Managed Care (MLTC) /Care Management Experience Required
- Prior Director Level or AVP Level experience preferred
Competitive salary and Compensation Package based on relevant MLTC Senior Director or AVP level experience!