TucsonAZRecruiter Since 2001
the smart solution for Tucson jobs

RN Director of Care Management

Company: P3 HEALTH PARTNERS
Location: Tucson
Posted on: June 15, 2019

Job Description:

RN Director of Care ManagementPeople. Passion. Purpose.At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients.We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance. --We are looking for a--RN Director of Care Management.-- If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization in Tucson, Arizona, then you should consider joining our team.----Overall Purpose:The Registered Nurse responsible for development and oversight of care management functions including concurrent review functions, staffing, and daily operations for multiple delegated managed care health plan contracts.---- A successful candidate will have the following experience and qualifications:Education and Experience:Bachelor's degree in Nursing in required. Master's degree in preferred.Minimum five years of clinical nursing experience, including a minimum of two years in a managed care/HMO organization, required.Minimum two years managerial experience over a managed care, medical management system required.Licensure: License / ability to obtain and current registration to practice as a Registered Professional Nurse in the states where P3 has contracts.Experience in care management and/or utilization management program set up, policy and procedure development for efficient programs, understanding of nationally recognized standards and guidelines (CMS and NCQA).--Experience in utilization management (UM) programs including concurrent review processes.--Experience applying medical management treatment guidelines and nationally recognized criteria, such as InterQual / McKesson, MCG, or other practical management guidelines required.Experience with standard operating procedure writing.Knowledge of CMS Star Ratings and components.Essential Functions:Knowledge of Medicare Advantage insurance structure and value based care.Collaborates with senior leadership in the development of department strategic goals and objectives to align with overall organizational goals and financial targets. Ensures program integration and implementation of Quality Improvement (QI) activities to ensure services provided meet the needs of the member.Works strategically to advance P3 Health Partners in the community and among health plan clients.-- Monitors metrics and staff performance to constantly meet or exceed all organizational targets.----Ensures compliance with all Federal & State Regulations and Requirements and Corporate Policies related to care management; utilization management; prospective / concurrent / retrospective care processes.Experience with State and external accreditation, managed care audits and reviews required.Assist National Senior Director of Medical Management, as needed.Ability to work independently under limited direction.Proficient with computer and software programs (e.g.; Microsoft Word, Excel) and the Internet required.Ability to learn internal and third-party software systems.Some travel required.Arizona Daily Star. Keywords: Clinical Services Director, Location: Tucson, AZ - 85726

Keywords: P3 HEALTH PARTNERS, Tucson , RN Director of Care Management, Executive , Tucson, Arizona

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Executive Jobs


DIRECTOR OF CLINICAL TRIALS
Description: The Director of Clinical Trials manages and participates in the clinical trial activities.
Company: Arizona Institute of Urology, PLLC
Location: Tucson
Posted on: 06/16/2019

Director of Nursing
Description: Job Description The Director of Nursing DON is a dynamic leader of the nursing department that is composed of nurses, nursing assistants, dieticians, nutritionists and administrative staff. The DON (more...)
Company: Acadia Healthcare
Location: Tucson
Posted on: 06/16/2019

Operational Risk Manager 4 - IT Regulatory Management
Description: At Wells Fargo, we want to satisfy our customers financial needs and help them succeed financially. Were looking for talented people who will put our customers at the center of everything we do. Join (more...)
Company: Wells Fargo
Location: Chandler
Posted on: 06/16/2019


Operational Risk Consultant 5 - PVSI Control - Data Management Risk
Description: Job Description br At Wells Fargo, we want to satisfy our customers financial needs and help them succeed financially. We re looking for talented people who will put our customers at the center of everything (more...)
Company: Wells Fargo
Location: Chandler
Posted on: 06/15/2019

Consulting Project Management Liaison with Security Clearance
Description: Job Description Consulting Project Management Liaison will oversee and coordinate the operational aspects of ongoing projects as liaison between the Standard Missile-3 program, functional organizations, (more...)
Company: Raytheon
Location: Tucson
Posted on: 06/16/2019

Director of Nursing - Diverse Candidates Encouraged
Description: Description Sierra Tucson, a world-renowned residential treatment center, is seeking a Director of Nursing. The Director of Nursing DON is a dynamic leader of the nursing department that is composed (more...)
Company: Sierra Tucson
Location: Tucson
Posted on: 06/16/2019

Technology Project Manager 3
Description: Technology Project Manager 3 Job Description At Wells Fargo, we want to satisfy our customers' financial needs and help them succeed financially. We're looking for talented people who will put our customers (more...)
Company: Wells Fargo
Location: Chandler
Posted on: 06/16/2019

Operational Risk Manager 4- Third Party Risk
Description: Job Description br At Wells Fargo, we want to satisfy our customers financial needs and help them succeed financially. We re looking for talented people who will put our customers at the center of everything (more...)
Company: Wells Fargo
Location: Chandler
Posted on: 06/16/2019

Business Systems Consultant - Case Management
Description: Business Systems Consultant - Case Management Job DescriptionAt Wells Fargo, we want to satisfy our customers' financial needs and help them succeed financially. We're looking for talented people who (more...)
Company: Wells Fargo
Location: Chandler
Posted on: 06/15/2019

1845 - Program Coordinator (Insurance Coord - Risk Management)
Description: 1845 Program Coordinator Insurance Coord Risk Management Job 2019 - 00627 Starting Salary: 47,528 AnnualThis position is in the Finance and Risk Management Department. Salary Grade: 51 Plans, (more...)
Company: PIMA COUNTY GOVERNMENT
Location: Tucson
Posted on: 06/16/2019

Log In or Create An Account

Get the latest Arizona jobs by following @recnetAZ on Twitter!

Tucson RSS job feeds