This position is responsible for operational management, account management, and business development for the Mississippi Utilization Management contract. Operational management includes team accountability for evaluation measures, deliverables or project requirements. Health management services may include: population health management, practice facilitation, medical/utilization management, case/disease/maternity management and/or quality improvement activities. The position will be responsible for monitoring compliance in accordance with client and contract deliverables as well as service/accreditation requirements as applicable.
Essential Functions
- You will manage the day to day operations of health management lines of service and/or contracts/programs, with particular emphasis on case management programs and care coordination initiatives. You will lead a team in the creation of a strategic plan, implementation of plan, evaluation and ongoing management to ensure contract deliverables/program requirements and evaluation measures/metrics are met and/or exceeded within assigned funding/budget. When deliverables/requirements are at risk, you will facilitate analyses and initiate action plans.
- You will develop and maintain relationships with team stakeholders. You will provide technical assistance, including issue research and resolution. You will develop and implement process improvement methods for an organization whose philosophy is continual improvement. You will ensure operations are completed in a timely, satisfactory, compliant manner within assigned funding/budget.
- You will participate in sales, business development and proposal work activities including development of concept papers, contributing content or review of proposals as a subject matter expert. You will also have financial accountability for monitoring budgets and financials for assigned contracts.
- You will coach, guide and directs team members to achieve individual, team and organizational objectives. You will provide resources and support as needed to meet the departmental and Company goals and specific contract/program requirements.
- You will represent the company and presents at meetings and/or conferences. You will work externally with providers or clients as assigned. You will make recommendations for improvements and/or efficiencies to management. You will Initiate opportunities to expand knowledge, skill development, and certifications which enhance quality improvement activities and the achievement of contract deliverables.
- You will stay abreast of industry trends and changes. Performs miscellaneous duties as assigned.
Requirements
- Two or Four year degree in nursing.
- Graduate of an accredited nursing program (ACEN, CCNE), with an active, unrestricted RN license
- 5 years experience in a healthcare environment with demonstrated expertise in care management, care coordination, and/health care quality improvement, including experience with case management and evidence-based clinical guidelines;
- 3 – 5 years managing projects and/or a professional staff;
- Demonstrated experience working in a fast paced and deadline driven environment;
- Positions working on specific contracts may require U.S. Citizenship.
Preferred Qualifications
- Knowledge of the following healthcare quality principles (Preferred):
- Health care services, health care organizations and programs
- Information management processes, electronic health records and healthcare information technology
- Quality improvement concepts, principles and process tools
- Basic statistics, data collection techniques, data analysis and graphic representation of data
- Knowledge of the following Leadership Principles
- Strategic planning, implementation and evaluation
- Leading Change
- Leading people: coaching, guiding and training
- Conflict management: difficult conversations
- Financial principals: budgeting
Who We Are:
Telligen is one of the most respected population health management organizations in the country. We offer clinical, analytical, and technical expertise to support local, Tribal, and national partners, state and federal government programs, and employers and health plans.
Over our 50-year history, health care has evolved - and so have we. What hasn't changed is our deep commitment to those we serve. Our success is built on our ability to adapt, respond to client needs and deliver innovative, mission-driven solutions.
Our business is our people and we’re seeking talented individuals who share our passion and are ready to take ownership, make an impact and help shape the future of health.
Are you Ready?
We’re on a mission to transform lives and economies by improving health.
Ownership: As a 100% employee-owned company, our employee-owners drive our business and share in our success.
Community: We show up - for our clients, our communities and each other. Being a responsible corporate partner is part of who we are.
Ingenuity: We value bold ideas and calculated risks. Innovation thrives when we challenge the status quo and listen to diverse perspectives.
Integrity: We foster a respectful, inclusive, and collaborative environment built on trust and excellence.
Thank you for your interest in Telligen!
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While we use artificial intelligence tools to enhance our initial screening process, all applications are thoroughly reviewed by our human recruitment team to ensure a fair and comprehensive evaluation of each candidate.
Telligen and our affiliates are Equal Opportunity Employers and E-Verify Participants.
Telligen will not provide sponsorship for this position. If you will require sponsorship for work authorization now or in the future, we cannot consider your application at this time. We will not accept 3rd party solicitations from outside staffing firms.
Telligen is an equal opportunity employer. Qualified applicants will be considered without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, protected veteran status, disability or any other protected class.
Telligen is committed to ensuring that our employment process is open to all individuals, and provides reasonable accommodations to individuals who need assistance during any part of the employment process due to a disability, medical condition, or physical or mental impairment. Reasonable accommodations are considered on a case-by-base basis.
If you need assistance to navigate Telligen’s careers website or to apply for a position, please send an email to [email protected]
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.