Provides regional leadership for joint Health Plan/TSPMG management efforts related to appropriate utilization of hospitals, transition of care, sub-acute care resources, hospital case management, and referrals to maximize the quality and efficiency of care provided to our members. Ensures that processes and systems are implemented for the patient to enter care at the optimal point in the care continuum and accesses appropriate levels of care with the goal of maximizing health status outcomes. Has a matrix relationship with TSPMG leaders and physicians to carry out the priorities defined by the health plan. Relocation, bonus plan and generous salary paid. Expect 10% travel. No sponsorship or remote work is available for this position. Basic Qualifications: Experience Minimum eight years (8) of previous experience either in acute care or ambulatory environment required. Minimum eight years (8) of management role experience in a health care setting with relevant experience in utilization management required. Minimum five years (5) of Managed Care background and experience in increasingly complex health care management roles with relevant experience in utilization management required. Education Master’s degree required in health care administration, nursing, business or related clinical field OR a bachelor’s degree with a minimum of six (6) years of directly related experience required. License, Certification, Registration N/A.
$118,000 - $165,000