RN MEDICARE ADVANTAGE PROGRAM MANAGER Position in SC

RN MEDICARE ADVANTAGE PROGRAM MANAGER
 

LOCATION:  SC

 

 
FACILITY DESCRIPTION: Large statewide managed care plan

 

 
REPORTS TO: Executive Director Clinical Consulting

 

 
POSITION DESCRIPTION: Note: Go live for program 01/01/2018

 
Develop and manage various health management programs including Case, Utilization and Disease Management as well as Behavioral Health and Healthcare Development with 3 nurses (eventually up to 25) – expect 6000 to 10,000 members.

 

 
Lead 3 nurses (eventually up to 25) – expect 6000 to 10,000 members.

 

 
One RN covers UM & is a Discharge Planner from hospital side, one RN worked on the program in 2014, one RN covers FEP (Federal Employee Program)

 

 
Assess impact of programs, perform cost-benefit/feasibility analyses.

 

 
Perform market research assessing corporate competitiveness.

 

 
Provides strategic direction for reporting including design, analysis and validation of outcomes and ROI.

 

 

 
REQUIRED EDUCATION/EXPERIENCE:

 

 
RN, BSN preferred. Must have Medicare Advantage experience!!

 

 

5+ years clinical experience. Strong leader!

 

 

2 to 5 years supervisory role or equivalent military experience grade E4 or above.

 

 

Experience developing, implementing and evaluating population health programs.

 

 

Ability to understand and communicate healthcare policy.

 

 

Active unrestricted RN license or NLC, unrestricted multi-state Compact license.

 

 

 

 

 
Contact:

 

 

 

 

Tina Roberts, President
JONATHAN CHASE EXECUTIVE SEARCH

 

 

 
588 Sutter Street, Suite 349
San Francisco, CA 94102

 

 

 
(415) 770-1200
(415) 684-2526

 

 

 
tinaroberts@contactjc.com

 

 

 

 

***Serving Clients with Interim and Permanent Recruiting Services since 2001