Manager of Health Management (RN) Mississippi

This position is responsible for operational management, account management, and business development for the Mississippi Utilization Management contract. Operational management includes team accountability for evaluation measures, deliverables or project requirements. Health management services may include: population health management, practice facilitation, medical/utilization management, case/disease/maternity management and/or quality improvement activities. The position will be responsible for monitoring compliance in accordance with client and contract deliverables as well as service/accreditation requirements as applicable.

Essential Functions

• You will manage the day to day operations of health management lines of service and/or contracts/programs, with particular emphasis on case management programs and care coordination initiatives. You will lead a team in the creation of a strategic plan, implementation of plan, evaluation and ongoing management to ensure contract deliverables/program requirements and evaluation measures/metrics are met and/or exceeded within assigned funding/budget. When deliverables/requirements are at risk, you will facilitate analyses and initiate action plans.
• You will develop and maintain relationships with team stakeholders. You will provide technical assistance, including issue research and resolution. You will develop and implement process improvement methods for an organization whose philosophy is continual improvement. You will ensure operations are completed in a timely, satisfactory, compliant manner within assigned funding/budget.
• You will participate in sales, business development and proposal work activities including development of concept papers, contributing content or review of proposals as a subject matter expert. You will also have financial accountability for monitoring budgets and financials for assigned contracts.
• You will coach, guide and directs team members to achieve individual, team and organizational objectives. You will provide resources and support as needed to meet the departmental and Company goals and specific contract/program requirements.
• You will represent the company and presents at meetings and/or conferences. You will work externally with providers or clients as assigned. You will make recommendations for improvements and/or efficiencies to management. You will Initiate opportunities to expand knowledge, skill development, and certifications which enhance quality improvement activities and the achievement of contract deliverables.
• You will stay abreast of industry trends and changes. Performs miscellaneous duties as assigned.

Requirements

• Two or Four year degree in nursing.
• Graduate of an accredited nursing program (ACEN, CCNE), with an active, unrestricted RN license
• 5 years experience in a healthcare environment with demonstrated expertise in care management, care coordination, and/health care quality improvement, including experience with case management and evidence-based clinical guidelines;
• 3 – 5 years managing projects and/or a professional staff;
• Demonstrated experience working in a fast paced and deadline driven environment;
• Positions working on specific contracts may require U.S. Citizenship.

Preferred Qualifications

• Knowledge of the following healthcare quality principles (Preferred):
• Health care services, health care organizations and programs
• Information management processes, electronic health records and healthcare information technology
• Quality improvement concepts, principles and process tools
• Basic statistics, data collection techniques, data analysis and graphic representation of data
• Knowledge of the following Leadership Principles
• Strategic planning, implementation and evaluation
• Leading Change
• Leading people: coaching, guiding and training
• Conflict management: difficult conversations
• Financial principals: budgeting