Senior Manager, Clinical Operations

Medical Informatics Company seeks business savvy Registered Nurse with experience leading a team and implementing best practices.

MedAssurant, Inc. is seeking a Senior Manager of Clinical Operations who will be responsible for managing the operations of the Michigan In-Market program.  MedAssurant’s In-Market program is directly correlated to CCS Advantage’s Disease Management Communications Center.  The Senior Manager will maintain compliance, based on best practice standards of care and regulations promulgated by CMS and other accreditation entities, with direct responsibility of assessing and coordinating healthcare for patients with diabetes, heart failure, CAD, COPD, asthma and other chronic conditions.  In addition, the Senior Manager is responsible for clinical and non-clinical staff development necessary for implementation of the Michigan In-Market program.  The ideal candidate will possess a BSN, RN license in the state of Michigan with Masters level trained and CDE preferred.

·         Fulfill the In-Market management  communication role between the Company, employees, healthcare providers, and members/patients of clients of the Company;

·         Identify the need and implement chronic care management interventions as guided by pre-established protocols and procedures, which includes conducting face-to-face clinical assessments of patients, educating and coaching patients in the area of diabetes, heart failure, CAD, COPD, asthma and other chronic conditions and making necessary referrals to appropriate healthcare providers;

·         Establish communication with local primary care and specialty physicians, clinical and non-clinical vendors and social resource agencies in an attempt to construct a patient-centric program dedicated to comprehensive clinical and psychosocial support for members;

·         Critically evaluate patients clinical cases through reviews of patients treatment plans and medical records/information;

·         Support the physician/patient relationship through ensuring physicians or providers are sent appropriate documentation or reports following patient encounters, providing medical care in accord with national guidelines, and are educated on the intent of the program and individual patient goals;

·         Interview, hire and orient staff to function in all In-Market roles of care management who are responsible for meeting with Members for the purpose of assessment, education and referral as deemed medically necessary;

·         Identify system enhancement necessary for improved member tracking, education and follow-up activities and coordinate the development with MedAssurant clinical development and IT staff.

Who we are:

MedAssurant, Inc. is a leading provider of nationwide medical data abstraction, analysis, and verification solutions for the U.S. healthcare industry. MedAssurant delivers unparalleled and truly end-to-end solutions to address matters of quality of care, cost improvement and containment, risk adjustment, clinical outcomes analysis, and healthcare data verification.

Originated in 1998 and headquartered outside of Washington, D.C. in Bowie, Maryland, MedAssurant also maintains primary offices in Annapolis, MD and Lansing, Michigan and other offices in many markets around the country. Employee field review staff and operations are maintained in all 48 continental States, the District of Columbia, and Puerto Rico. Our track record of superior customer service is the result of a commitment to excellence shared by all of MedAssurant personnel. This commitment is fostered by a dynamic, energetic, and team-oriented company culture.

We offer competitive salaries and a comprehensive benefits package including Medical and Dental insurance, 401(k) plan, Life Insurance, Vision and Prescription Coverage, PTO (paid time off) and seven corporate holidays. 

If you enjoy a culture that rewards passion and creativity, we want to hear from you!