Directeur d'expérience en certification at Demers Beaulne overseeing audit strategies and managing team performance in a hybrid setting with professional development opportunities.
About the role
- Director II managing care management programs and leading clinical teams at Elevance Health. Focused on member outcomes, quality performance, and comprehensive care management oversight.
Responsibilities
- responsible for the strategic leadership and operational oversight of care management programs
- leads clinical teams to improve member outcomes
- drive quality performance (including FEP HEDIS measures)
- ensure cost-effective use of healthcare resources
- accountable for program execution, process improvement, and compliance with all contractual, regulatory, and accreditation requirements
- oversee care management operations that may range from single-site to large, multi-site, multi-state environments
- manage and develop clinical staff
- monitor performance metrics
- lead quality improvement initiatives
- engage with key accounts
- drive program design and redesign efforts that impact members.
- collaborate with internal and external stakeholders to resolve issues
- oversee budgets, resource planning, and special projects
- build and sustain a high-performing team through hiring, coaching, mentoring, and performance management
Requirements
- Bachelor’s degree in Nursing
- a minimum of 8 years of healthcare experience, including management experience
- Current, active, unrestricted RN license in applicable state(s) or U.S. territory required
- Master’s degree or advanced degree in nursing, business, or healthcare-related field preferred
- Experience in population health, HEDIS performance, and multi-state or multi-product health plan operations are strongly preferred
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical benefits
- dental benefits
- vision benefits
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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