Healthcare

DIRECTOR I MEDICAL MANAGEMENT - IHM 

ST. LOUIS, MO 

Healthcare

Exp 2-5 years

Deg Bachelors

Relo

Bonus

Job Description

Responsible leading multiple teams of clinicians charged with promoting quality member outcomes, to optimize member benefits, and to promote effective use of resources. Primary duties may include, but are not limited to:

• Ensures adherence to medical policy and member benefits in providing service that is medically appropriate, high quality, and cost effective.

• Manages areas which may include utilization management, case management, disease management and demand management.

• May also manage appeals for services denied.

• May also manage budget and special projects.

• Ensures adherence to all contract, regulatory and accreditation requirements.

• Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Qualifications

• Requires a BS in a related health care field or nursing 

• 5 years of experience in a health care environment (i.e. acute care) including management experience; or any combination of education and experience, which would provide an equivalent. 

• MS or advanced degree in a clinical nursing specialty, business or healthcare-related field preferred. 

• Current unrestricted RN license in MO is a plus.

Bonus: 12.5-17.5%

All your information will be kept confidential according to EEO guidelines.

Direct Staffing Inc