Director of Clinical Services, Faculty Practice Group Management Services Organization

Description

We are seeking a highly skilled and dynamic Director of

Clinical Services to lead the development, evaluation, and implementation of

multiple clinical programs and medical services with an emphasis on optimizing

Utilization Management for the Faculty Practice Group (FPG) Management Services

Organization (MSO). Reporting to Chief

Medical Officer of Faculty Practice Group and Medical Group, this role is pivotal in ensuring the

delivery of program functionalities in all aspects of Utilization Management

and its integration with other patient facing programs within the MSO . You will oversee and direct key initiatives,

ensuring that MSO members enrolled in various health plans receive

high-quality, integrated care.

You will : Oversee

the development and execution of multiple UM processes and workflows, while continuously

identifying and evaluating areas for improvement and potential innovations to

be implemented

Oversee

the development and execution of needed points of integration aimed at

enhancing healthcare delivery for MSO members.

Ensure

seamless integration of various clinical functions with Utilization

Management, such as Case Management, Quality Improvement, Credentialing,

and Health Plan Relations to improve overall healthcare services and

control healthcare costs.

Collaborate

with internal and external stakeholders to ensure cohesive and effective

program delivery, while supporting value-based care initiatives.

Build

and maintain strong relationships with key stakeholders, including

members, health plans, and clinical teams, to ensure the effective

execution of health programs and services.

Direct and mentor staff members, ensuring clear

communication, effective teamwork, and high-performance standards.

Salary Range : $144,400 - $341,800 / annually

Qualifications

We're seeking an experienced leader with :

A Registered Nurse License, Advanced Practice

Provider (Nurse Practitioner or Physicians' Assistant), or equivalent

Bachelor's degree in relevant discipline,

required

Master's degree in relevant discipline, highly

desired

3-5 years of experience in a clinical capacity

(RN, APP, etc.), required

3-5 years of executive leadership experience with

a focus on Utilization Management for a medical group, IPA, or Health Plan, required

In-depth understanding of managed care, MSO

functions, and population health services, required

Experience and successful achievement of

healthcare MSO certification and recognition programs

Strong communication skills with all levels of

staff and stakeholders

Ability to navigate and perform duties within a

complex, matrixed organization

Leadership capabilities that demonstrate

openness to change and the ability to implement innovative programs that align

with strategic initiatives

Exceptional interpersonal, written, and verbal

communication skills

Proficiency in Microsoft Office applications

(Word, Excel, PowerPoint)

Ability to function independently with sound

judgement in decision-making and take initiative when needed while

appropriately soliciting input or advice