Professional Services Director - Healthcare oversees the administrative and operational support of the facility's clinical programs. Assists in the development of departmental policies, procedures, and budgets. Being a Professional Services Director - Healthcare ensures compliance with established policies. Requires a Bachelor's degree. Additionally, Professional Services Director - Healthcare typically reports to top management. The Professional Services Director - Healthcare manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Professional Services Director - Healthcare typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)
Seeking RN, LPN, LMSW or MSW to be responsible for health care management and coordination of members to achieve optimal clinical, financial and quality of life outcomes. MUST reside in the state of VIRGINIA. Schedule M-F 8:00am-5:00pm.
Day to Day Responsibilities: Will be responsible for performing case management activities according to the contractual requirements and in alignment with NCQA requirements. This will include potential home visits to complete assessments as well as completion of telephonic assessments, completion of integrated care plans, and conducting interdisciplinary care team meetings. In addition, conducting needed telephonic follow-up, education, and care coordination for assigned members.
Must Have Skills:
• Must have a valid driver’s license and reliable vehicle for field visits
• Excellent communication skills, with an ability to communicate effectively with members with chronic conditions, developmental disabilities, etc.
• Strong technical skills (utilizing multiple programs at the same time) along with competency in Microsoft applications (Outlook, Teams, Excel, etc.)
• Strong organizational and interpersonal skills
Required Years of Experience: One year of experience working directly with individuals who meet the Cardinal Care Priority Population (Medicaid) criteria.
Required Licensure / Education: Must have Bachelor’s degree in a health or human services field, LMHP, RN/LPN, QMHP, LMSW, LBSW, MSW or BSW
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