VP Case Manager – Position Available In Broward, Florida
Tallo's Job Summary: The VP Case Manager oversees maternal/child care health plan programs, ensuring they operate within defined parameters. Responsibilities include budget management, product development, and policy implementation. Requirements include a Bachelor's degree and 10+ years of managed health care experience, with a focus on managing programs for pregnancy. The employer is an equal opportunity employer.
Job Description
Job Description:
This VP Case Manager Position position
Purpose:
Oversee maternal/child care health plan programs, including TANFand CHIP. Ensure all maternal/child programs are designed,implemented, and operated within defined parameters.
Position Responsibilities:
o Oversee budgets, revenue targets and P&L related activitiesfor all maternal/child programs o Lead strategies for product development and implementation forall maternal/child programs o Guide overall performance of health plan as an integral part ofthe health plan leadership o Lead and support medical management programs and processes tomeet health plan and state goals o Lead and support network plan including contracting and providerrelations for providers to meet health plan and state goals o Direct the development and implementation of policies ≺ocedures, work processes, financial reporting, compliance,systems, ensuring metrics are established and measured o Ensure the corporation’s strategic objectives are maintained atthe health plan, and all organizational, state, compliance andcontractual agreement requirements are met o Develop and maintain key state and federal relationships,coordinate and participate on departmental and state committees,and other activities, meetings and trainings o Participate in the integration of specialty products inmaternal/child populations
Knowledge/Experience:
Bachelor’s degree in Social Work, Health care Administration,Business Administration or related field. 10+ years of managedhealth care operations, administration and management experience.
Knowledge of case management practices, managed care, Medicaid andCHIP populations preferred. RN preferred. Strongest need is for someone who has had experience in managingprograms for pregnancy – high risk, NICU, and secondary moreroutine pediatric cases – not the complex or medically fragile.
They will be under the complex VP. Managed care experience isreally essential. If they were a Director in another Medicaid plan.
Or if have had experience in a senior leadership role in a HealthyStart program and worked with a managed care plan that would be agood fit. We are an equal employment opportunity employer and will considerall qualified candidates without regard to disability or protectedveteran status.
