OverviewThe Vice President of Care Management Solutions leads and oversees the operations of VNS Health’s Care Management Organization (CMO), which partners with health plans to provide exceptional care for targeted groups of members. We are looking for an innovative leader who will shape and execute strategies that drive evidence-based solutions, ensuring strong quality outcomes and a seamless member experience. If you have the expertise and passion for delivering optimized care programs for high-risk members, including chronic disease management, complex case management, and preventive care initiatives, then please apply today. We look forward to engaging you in exploring this critical role for our organization, which represents an amazing career opportunity to impact our approach to healthcare!
Compensation:$193,600.00 - $258,200.00 Annual
What We Offer
Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
Employer-matched 401k retirement saving program and opportunity for both pre- and post-tax contribution
Personal and financial wellness programs
Pre-tax flexible spending accounts (FSAs) for healthcare and dependent careand commuter transit program
Generous tuition reimbursement for qualifying degrees
Opportunities for professional growth and career advancement
What You Will Do
As the VP of Care Management Solutions, a typical “day in the life” may include:
Developing and implementing the strategic goals for care management organization, aligning with VNS Health enterprise goals, and responding to industry trends and health plan client needs.
Building strong relationships with health plan clients, understanding their unique needs, and ensuring high levels of satisfaction and value delivery.
Participating in the business development process to expand the network of health plan clients
Developing utilization management programs to ensure appropriate and cost-effective use of health care services. Monitoring utilization patterns, implementing strategies to prevent overuse or misuse of services, and ensuring adherence to clinical guidelines and best practices.
Ensuring compliance with relevant regulations, standards, and best practices. Identifying and mitigating risks related to care management operations.
Establishing and proactively monitoring key performance metrics to assess the effectiveness and efficiency of care management programs. Driving continuous improvement through data-driven insights and feedback.
This role may be for you if:
You can seamlessly blend your strategic insight with a “roll up your sleeves” approach to operationalizing programs and initiatives.
You are a healthcare leader who stays abreast of industry developments, emerging technologies, and best practices – and finds a way to incorporate them into your approach and business plan.
You are passionate about leading, mentoring, and developing a high-performing team of care management professionals.
You excel at analyzing complex data and translating insights into actionable strategies.
You identify with our core values of empathy, integrity, and agility – and have the willingness and the ability to weave them into all aspects of your work.
QualificationsTo be considered for this opportunity you must have a minimum of a Bachelors degree in Nursing or a related field. A Masters degree or higher in a related field is strongly preferred. For you to excel in this role you will need a minimum of 10 years of experience in health care management, with at least 5 years in a senior leadership role focused on care management or related areas. You must possess a demonstrated, deep understanding of care management strategies, health plan operations, risk management, and regulatory compliance. Knowledge of value-based care models and population health management is highly desirable.
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