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Director of Outpatient Care Coordination

The Director of Health Alliance Outpatient Care Coordination is responsible for planning, organizing, budgeting, and directing the assigned regional operations for Medical Management services. The Director is in a dynamic position to impact the transitionof care of the member across the care continuum, work with all levels of providers and stakeholders, support the financial well-being of the organization and most importantly, drive quality and value-based member outcomes. The Director applies leadership andmanagement skills to building strong and productive relationships across the broad spectrum of external organizations that include health systems, provider, vendor and regulatory agencies. The Director coordinates duties with appropriate personnel to meetoperational program needs, ensures compliance with state and federal health plan requirements, Medicare guidelines and URAC/NCQA standards; develops and implements policy and procedures; updates and integrates current clinical practice guidelines; performsemployee counseling, performance appraisals, and oversights employee training, coaching and development. The success of this position requires the ability to foster communication and teamwork between physicians, market care management team, case, utilization,disease and transition of care management staff, corporate departments, vendors, and senior leadership. This position is responsible for strategic planning, oversight and evaluation of all Medical Management programs. The Director will assist senior leadershipwith long-term planning initiatives to maintain operations assuring activities are appropriately integrated into overall Health Alliance strategic direction, as well as the mission and values of the company.
EDUCATIONAL REQUIREMENTS
Bachelors Nursing

CERTIFICATION & LICENSURE REQUIREMENTS
RN License Illinois. Case Management Certification obtained within 18 months of hire.

EXPERIENCE REQUIREMENTS
Five (5) to seven (7) years of progressive nursing experience in an integrated healthcare setting with a minimum of three (3) years at a recent management level of manager or above required. Three (3) or more years of experience working in a health plan environment required.

Time:  Full time
Salary:  Salary
Category:  Operations

Updated: 3/5/2019 10:55:32 AM