At Convey our mission is to improve health plan operations and elevate the customer experience. We are seeking a strong business-oriented and hands-on Vice President of Clinical Services to manage our clinical services offering for the Supplemental Benefits Administration (SBA) group.
Job Summary:
This position works in tandem with senior leadership to develop and lead Convey’s clinical services support offering within the Supplemental Benefits Administration (SBA) program.
Essential Responsibilities:
- Must be capable of collaboration with health plan/client key positions such as Executive Staff/Director of Quality and Medical Management, Medical Directors, Health Plan Operations and HEDIS/IT Health Informatics. This position is responsible for the participation in, and coordination of, client clinical projects which may include but are not limited to:
- Outlined initiatives and strategies aimed at measuring, analyzing and improving the MAPD Star Rating measures and related patient outcomes
- Ensure the accuracy and completeness of information used for measuring and reporting performance outcomes.
- Responsible for oversight, managing and monitoring outreach and intervention activities, and other project as assigned. This may include intervention/outreach development, outcomes analysis, data trending, and program planning.
- Must have working knowledge and experience in care management, data analytics, measurement reporting.
- This position must maintain general knowledge of regulatory requirements within the Medicare Advantage industry.
- Responsible to support all client projects that require plan clinical or operational expertise.
- Responsible for client projects, including projects not managed directly.
- Responsible for the development of new, and refining of existing scopes of work to assure they meet the industries and/or client current needs.
- Provide day-to-day oversight of staff deployed on projects.
- Participate fully in the business development cycle including marketing activities, proposal generation, and sales activities.
- Coordinate strategies for client development in conjunction with appropriate colleagues.
Education & Experience:
- Bachelors Nursing or Masters Degree in Healthcare Management (MPH or MHA), or related field preferred
- 5-7 years of experience in clinical practice
- Have at least 5 year’s experience within a healthcare company and/or Medicare Advantage plan or other capacity in the clinical quality area, care management, complex care, nursing, operations
- Understanding and interpretation of all applicable CMS Medicare Part C & D requirements including manuals, review guides and Code of Federal Regulations
- Communicate clearly with internal partners and external regulatory agencies and effectively represent the client’s and Convey’s interests
- Establish positive partnerships across business groups both inside and outside of the organization
- Monitor a wide range of activities, participate in multiple projects, and act as a catalyst to ensure execution
Benefits:
- Medical, dental & vision plans
- 401 K Plan, including company match
- Life Insurance – company paid & voluntary
- Short & Long term disability
- Discounts and savings options
- Company engagement sponsored event
Job Type: Full-time
Experience:
- relevant: 5 years (Preferred)
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