Clinical Manager
Location: Albany New York
Description: BCforward is at present recruited Clinical Manager right now, this career will be placed in New York. For complete informations about this career opportunity please read the description below. Job Description:
Position: Clinical Manager
Location: Albany, NY
Rate: Negotiable
Management of the prior authorization staff
Accountability for all service del! ivery requirements and quality
Be the primary liaison/point of contact with the State for prior authorization and clinical policies and procedures
Provide advice and recommendations that are related to the clinical quality and cost management of the program
Provide advice and recommendations to clinical claims reviews
Lead the implementation and ongoing operation of Utilization Management
Provide primary oversight of all utilization management, including service authorization processing and quality
assurance
Maintain primary accountability for the accuracy and validity of clinical business rules
Provide support for reporting, queries, and clinical business intelligence
Requirements:
Active New York Registered Nurse licensure
Seven (7) or more years' experience in direct clinical management role
Seven years or more in leadership roles of staff greater than 50 employees
Demonstrated ability to effectively communi! cate with customer's senior management
Demonstrated strong! analytical, organizational and problem solving abilities related to clinical best practice
Three (4) years' experience in the health care insurance industry, such as: claims, provider relations and/or managed
care
Administer policies and procedures for utilization control
Monitor referral patterns and make recommendations on strategies to contain costs, improve access, and ensure
quality care
Ensure implementation of practice guidelines and referral criteria as directed by the State
Interact in a multi-disciplinary team environment
Provide clinical supervision to ensure effective utilization of services
About BC forward
BCforward began as an IT business solutions and staffing firm. Founded in 1998, BCforward has grown with our customers' needs into a full service personnel solutions organization. BCforward's headquarters are in Indianapolis, Indiana and also operates delivery centers in 17 locations in North America as well as H! yderabad, India and Puerto Rico. We are currently the largest consulting firm and largest MBE certified firm headquartered in Indiana. With 14+ years of uninterrupted growth, the addition of two brands (Stafforward and PMforward) and a team of more than 1400 resources our teams deliver services for multiple industries from both public and private sectors. BCforward's team of dedicated staffing professionals has placed thousands of talented people over the past decade, with retention rates that are consistently higher than the industry average.
www.bc forward .com
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If you were eligible to this career, please email us your resume, with salary requirements and a resume to BCforward.
If you interested on this career just click on the Apply button, you will be redirected to the official website
This career starts available on: Wed, 02 Oct 2013 06:24:52 GMT