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Director of Medical Management

The Judge Group Sacramento Full-Time
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Judge Healthcare is actively seeking a Director of Medical Management for one of our premier managed care clients in the Sacramento, CA area.

This job will have the following responsibilities: 
  • Manages the activities of staff providing leadership and guidance. 
  • Interviews, recommends for hire, and evaluates staff, and counsels and confronts unsatisfactory performance promptly and fairly and administers corrective action.
  • Identifies department goals and objectives, develops and communicates action plans through regular staff meetings and other communications, uses team approach to problem solve and sets clear expectations. 
  • Identifies training needs and develops and participates in staff training. 
  • Provides a challenging and supportive environment and delegates appropriately. 
  • Analyzes work plans developed by subordinate managers and monitors the status of their work in relation to the overall schedule requirements.
  • Develops monitoring systems and measurements and exhibits a customer service philosophy. 
  • Manages statistical and qualitative information concerning patient outcomes and physician/hospital practice patterns in accordance with health plans’ utilization standards. 
  • Intervenes with hospital or physician contractors to examine cases to ensure methods for meeting these utilization standards while maintaining precedent for quality of case standards. 
  • Determines and enforces medical management requirements in accordance with real company needs, based on current regulations and state-of-the art product development. 
  • Organizes and promotes medical management functions.
  • Evaluates and develops improved techniques for the control of quality and reliability. 
  • Plans and develops improved techniques for the control of health care costs. 
  • Plans, on a quarterly or longer basis, the overall use of resources. 
Qualifications & Requirements:
  • Active CA RN license in good standing.
  • Bachelor’s degree in Nursing or equivalent.
  • Five years clinical experience in an acute care setting.
  • Four years experience in quality management/improvement in a health care setting.
  • Two years work experience in a managed care environment.
  • Five years management experience in a health care setting. 
If at all interested, please send your most up to date resume to Email blocked - click to apply or apply directly.

Best regards,
David Whiteman
 

Skills required

Healthcare Effectiveness Data And Information Set
Managed Care
Medicare
Primary Care
Medicaid
Fiscal Policies
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Job ID: 619807

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The Judge Group is a privately owned, leading professional services firm with nearly 50 years of experience in providing technology, talent, and learning solutions. Our services are successfully delivered through a network of more than 35 offices in the United States, Canada, and India. The Judge Group serves more than 47 Fortune 100 companies and is responsible for 7,000 professionals on assignment annually across a wide range of industries.

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