(Archived) CLINICAL DIRECTOR OF POPULATION HEALTH & MEDICAL MANAGEMENT

Position Overview: Leads clinical and administrative operations for Optum care of New York (OCNY) Population Health and Medical Management Department. Function is responsible for directing clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating). This includes case management, coordination of care, and medical management consulting, health education, coaching and treatment decision support. Establishes effective partnerships with hospitals, skilled nursing facilities, home care agencies and other community-based organizations to develop a network for provision of high quality of care. Provides leadership to and is accountable for the performance and direction through multiple layers of management and senior level professional staff. Work most often impacts a large business unit, or multiple markets/sites.

Required Qualifications:

• Current, unrestricted NYS RN license required
• Bachelor of Science in Nursing, Healthcare Administration, or a related field
• 10+ years of diverse clinical experience; preferred in managed care (delegated medical management), Complex Case Management, Disease Management and Transitional Case Management
• 5+ years of recent leadership experience with ability to partner with staff to build high-performing teams.
• Expert knowledge of case management principles, as evidenced by certification in Case Management (CCM) or willing to obtain within 6 months of employment.
• Knowledge of relevant state and federal guidelines (e.g., Medicare, Medicaid, SNP, Commercial) and regulatory bodies (e.g., CMS, NCQA, URAC, InterQual)
• Solid leadership skills, demonstrated by the ability in leading large teams of individuals to successful outcomes
• Experience managing direct reports to performance metrics
• Proficient with Microsoft Office applications including Word, Excel, and PowerPoint
• Willing to occasionally travel as deemed necessary

Full COVID-19 vaccination is an essential requirement of this role. CareMount will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance.

All qualified applicants will receive consideration for employment without regard to race, ethnicity, color, religion, sex, gender identity, sexual orientation, national origin, disability, or protected veteran status. CareMount is an EO employer – M/F/Veteran/Disability