Vice President, Medical Management
Confidential
Vice President, Medical Management
About the Company
Pioneering continuing care organization for individuals with chronic care needs
Industry
Hospital & Health Care
Type
Non Profit
Founded
1977
Employees
1001-5000
Categories
- Health Care
Specialties
- managed long term care
- nyc
- chronic care needs
- rehabilitation
- care management
- medicare
- medicaid
- health
- seniorcare
- healthcare
- and health plans
Business Classifications
- B2C
- B2B
About the Role
The Company is seeking a Vice President for Medical Management to serve as the physician lead for a range of medical management functions. This includes Utilization Management, Care Management, and population health management initiatives. The successful candidate will be responsible for developing and executing medical cost management and healthcare quality and affordability initiatives, as well as engaging with the company's network of physicians and other practitioners. The role also involves providing physician leadership for engagement with risk-sharing groups, leading clinical initiatives, and ensuring compliance with state and federal regulatory requirements. Applicants for the Vice President for Medical Management position at the company must be board-certified physicians with a minimum of ten years of experience, including both clinical practice and management roles. The ideal candidate will have a background that includes experience in a managed care organization or accountable care organization, with a focus on all lines of business, including Medicaid, MLTC, and Medicare. The role requires a candidate with a medical degree from an accredited medical school, board certification in at least one area, and an unrestricted license to practice medicine in New York State. The Vice President will also be involved in key external meetings, work with the Compliance Department on cases of potential overuse and fraud, and participate in the development of responses for escalated member or provider issues.
Hiring Manager Title
Executive Vice President, Clinical Services and Network Management
Functions
- Medical Care/Hospital Administration
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