What are the responsibilities and job description for the Market Clinical Director Population Health, RN position at Perform RX?
Your career starts now. We're looking for the next generation of health care leaders.
At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.
Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.
Responsibilities:
The Market Clinical Director, Population Health is responsible for market specific clinical operations supervising all UM, ICM, and RROT staff and ensuring all market activities conform to enterprise program descriptions, policies and procedures.
- Oversight of execution of market specific clinical programs including UM, CM, RROT, and Bright Start.
- Assures compliance of program execution with enterprise policies.
- Monitors performance metrics across multiple LOBs and assures that appropriate action is taken to address performance opportunities consistent with enterprise policies.
- Responsible for market specific contract and accreditation compliance related to Population Health Clinical Operations.
- Supervises market specific Population Health Clinical Operations staff.
Education/Experience:
- Bachelor's Degree in Nursing or healthcare related field required. Master's Degree preferred.
- Current RN license in New Hampshire or Nurse Licensure Compact.
- CCM certification upon date of hire (preferred). Must be obtained within 2 years of hire.
- Minimum of 3 years of progressive management experience (including staff management) in a managed care environment.
- Minimum of 3 years of experience with Managed Medicaid clinical programs.
- Minimum of 3 years of experience managing Case Management and Utilization Management programs. (preferred)
- Minimum of 3 years of experience in CM and UM program design, implementation to include experience in setting, communicating and implementing strategic direction. (preferred)
Diversity, Equity, and Inclusion
At Amerihealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
We keep our associates happy so they can focus on keeping our members healthy.
Our Comprehensive Benefits Package
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.
