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Senior Manager, Network Programs

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Location
Chicago, IL
Salary
$100,000 - $120,000
Job Type
Direct Hire
Date
Sep 07, 2017
Job ID
2519947

Senior Manager, Network Programs
This is a full time permanent opportunity with a growing national managed care organization. This position is responsible for managing the functions of delegated utilization, case, and disease management oversight, physician quality oversight, and accreditation for commercial, exchange, and government HMO networks.  Manages a professional nursing staff engaged in quality improvement activities and cost containment initiatives.  Manages non-clinical staff engaged in monitoring of network provider offices and chart review.  Manages the NCQA and URAC accreditation activities and ensures compliance with standards.


Requirements:

  • Bachelor Degree and 5 years in Health Care Setting
  • Registered Nurse with 5 years of clinical experience to the consumer
  • 3 years leadership, supervisory, or management experience; Experience in Case Management, Utilization Management and Disease Management
  • Knowledge of regulatory and accreditation requirements and standards (NCQA,URAC) 
  • Experience in managing delegated oversight & government programs.


Benefits:

  • Salary plus bonus, and a robust benefits including Health Insurance, tuition reimbursement, and 401k employer match, etc. 

 
Who We Are
Headquartered in Central Florida, Pivotal Placement Services is a full-service national workforce solutions firm that specializes in placing healthcare professionals from staff to leadership with both clinical and non-clinical employers. Our Comprehensive and Customer Focused Workforce Solutions include, Right-to-Hire Contract Staffing, Direct Placement, and Managed Service Provider (MSP) / Vendor Managed Services (VMS) engagements nationally. Pivotal Placement Services is an Equal Opportunity Employer.