LOCATION: Columbia, SCFACILITY DESCRIPTION: Large statewide managed care planREPORTS TO: Executive Director Clinical ConsultingPOSITION DESCRIPTION: (Note: go live for program 01/01/2018) Develop and manage various health management programs including Case, Utilization and Disease Management as well as Behavioral Health and Healthcare Development with 3 nurses (eventually up to 25) expect 6000 to 10,000 members. Lead 3 nurses (eventually up to 25) expect 6000 to 10,000 members.One RN covers UM & is a Discharge Planner from hospital sideone RN worked on the program in 2014,one RN covers FEP (Federal Employee Program) Assess impact of programs, perform cost-benefit/feasibility analyses. Perform market research assessing corporate competitiveness. Provides strategic direction for reporting including design, analysis and validation of outcomes and ROI.REQUIRED EDUCATION/EXPERIENCE: RN, BSN preferred. Must have Medicare Advantage experience!! 5+ years clinical experience. Strong leader! 2 to 5 years supervisory role or equivalent military experience grade E4 or above Experience developing, implementing and evaluating population health programs Ability to understand and communicate healthcare policyActive unrestricted RN license or NLC, unrestricted multi-state Compact licenseExcellent bonus + interview and relocation program. Merit review Mar. through May depending on start date.
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