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Medical Management Director

April 30, 2013 - June 15, 2013
Location:San Antonio, TX
Salary Range:competitive
Exempt/Non-Exempt:Exempt
Benefits:competitive
Employment Type:Full Time
Department:Administration
Description:The Director of Medical Management is a key member of the Medical Management team and oversees Case Management, utilization Management and social services. Works closely with Leadership team to ensure and improve efficiency, quality of care, resource utilization, clinical documentation, service excellence and work flow. Collaborates with clincial and adminsitrative leadership, Physicians, Physician Assistants and other staff to ensure expectations and goals are met. The Director establishes appropriate standards and ensures compliance with established policies/procedures, applicable laws, regulatory requirements, codes of practice, etc. Assesses and continiously improves skills of staff, provides needed training, direction and guidance to ensure compliance with established work standards.
Duties:* Responsible for regulatory audit participation
* oversight of Case Management & UM team
* Implementation of standard operations procedures
* Evaluate and monitor regulatory quality measures, case management, utilization management and Physicians expectations
* submit analysis and report data for all Um activities HTMG leadership & committee.
* Conduct monthly staff meetings and employee 1:1's and provide training, coaching and counseling as needed
* Ensures that the case management program provides for appropriate and cost effective medical, medically-related social services and behavioral health services are identified, planned and obtained where needed.
Qualifications:BSN required-Master's (MSN,MHA,MBA, MPH) preferred
Previous leadership over Case Management team
Effective and proactive use of perfromance metrics
Strong reporting and presentation skills
excellent interpersonal abilities, Patient service standards


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