Clinical Director - Early Childhood Support Services

October 24

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Magellan Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1994

⚕️ Healthcare Insurance

💰 $101M Private Equity Round on 2004-01

Description

• Oversight and monitoring of ECSS site-developed assessments and Plans of Care. • Monitor, analyze, and implement interventions based on data. • Train and monitor ECSS Sites for compliance with best practices. • Participate in Quality Improvement activities including data collection and analysis. • Maintain accountability for medical management functions for health plan outcomes. • Oversee utilization management and criteria-based reviews of care. • Conduct staff audits and process audits. • Review audit results and manage trainings for individual/unit learning gaps. • Support goals and accreditation for health plan in clinical reviews. • Develop and coordinate education programs for vendors, providers, and staff. • Prepare monthly performance reports with audit results and present findings.

Requirements

• 3+ years in utilization management operations. • 5+ years in health care quality improvement. • Licensure required: current license meeting State or customer-specific requirements. • Experience overseeing contractual performance standards. • Experience with reporting and analyzing managed care utilization data. • Strong verbal and written communications skills.

Benefits

• Short-term incentives and comprehensive benefits package. • Health, life, and voluntary benefits. • Benefits to enhance physical, mental, emotional, and financial wellbeing.