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Director of Clinical Programs -RN

Company: Meritage Medical Network
Location: Novato
Posted on: May 9, 2022

Job Description:

The Meritage Director of Clinical Programs is a leadership role that develops, manages, and directs the organization's Clinical Program departments including: Utilization Management, Care Management, Quality, and Risk Adjustment. The specific programs the director oversees include complex care management, care transitions, utilization management, correct coding, ACO programs, as well as quality improvement programs and initiatives. The director is responsible for the development and adherence to policies and procedures related to each of the areas of responsibility to assure compliance with all health plan and government requirements. The director maintains active relationships with key health plan representatives and is responsible to ensure the organization passes all required audits, which include HEDIS and NCQA.

Qualifications, Education, Experience and Requirements
Bachelor of Science Degree in healthcare-related field; Nursing preferred; Master's degree preferred
Unrestricted Registered Nurse (RN) license required
5-7 years of management experience, preferably with increasing level of responsibility
Previous experience in quality reporting
Previous experience in discharge planning, Utilization Management, Care Management, and population health preferred
Previous experience in developing clinical and/or quality programs

Keywords: Meritage Medical Network, Novato , Director of Clinical Programs -RN, Executive , Novato, California

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