Job Ref: 102619
Category: Utilization Review and Case Management
Department: UTILIZATION MANAGEMENT
Location: 50 Water Street, 7th Floor,
New York,
NY 10004
Job Type: Regular
Employment Type: Full-Time
Salary Range: $340,000.00 - $350,000.00
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Position Overview
Responsible and accountable to the Chief Medical Officer for helping to manage health plan medical quality, utilization, and assuring appropriate health care delivery, the Senior Director of Medical Directors
serves in a policy, operational and strategic capacity. The Senior Director of Medical Directors overall purpose is to work across medical management functions, with a focus on Utilization Management and Business Intelligence, and across all lines of business and pharmacy. This is a broad function that includes day-to-day operations, data and reporting design, high-level strategy, planning, and policy involvement.Licensure and/or Certification Required
Professional Competencies