Director, Clinical Care Management & Quality

  • Full Time
  • Stamford, CT
  • Salary: $160000.0

Smith Arnold Partners

We are offering an incredible opportunity to join one of the most progressive and busiest IVF centers. Work alongside innovators of cutting-edge research developers in an active setting that not only treat infertility but explore new and better technologies to help couples achieve pregnancy.
The organization is transforming individuals lives for the better, and they are looking for a dedicated professional to join a successful and growing team.

This is a perfect opportunity for a Quality Management professional striving for career growth and the chance to making a difference in the lives of our future generation!

Title: Director of Quality & Clinical Care Management
Salary: $140,000 – $160,000 + Competitive Benefits Package
Location – Rye Brook, NY

The Director of Care Management plans, organizes, implements, and directs care coordination activities. The Director is responsible for providing oversight and broad direction and strategic planning to Care Management which includes care planning, coordination, utilization management. The Director of Care Management works closely with the CEO and VP of Clinical Services

JOB RESPONSIBILITIES:
• Leads the clinical activities of the utilization management team by direct supervision of Care Managers, leads and administrative staff.
• Conducts clinical peer reviews of UM decision making of Care Managers.
• Interacts with patients and providers associated with the active management of the patient’s care, when necessary or requested due to escalation, to ensure patient needs, treatment, and/or proper protocol is handled correctly.
• Prepares reports for and participates in monthly Utilization Management and Quality Assurance/Improvement committee meetings.
• Participates in reviews of all denials and assesses whether company protocols and procedures as well as state mandates were followed in such a way as to assure good medical care was provided.
• In the absence of the VP, Clinical Services & QA, may assist sales team with clinical aspect of client meetings and calls acting as subject-matter expert for best practices, evidence-based guidelines, and current trends in fertility management.
• Collaborates closely with VP, Clinical Services & QA to ensure all initiatives are aligned to strategic goals and are integrated throughout the company.
• Participates in process improvement and development to make recommendations within the scope of accountability
• Maintains current knowledge of women’s health issues including new trends in technology, intervention, and prevention strategies.
• Attends continuing education programs to augment clinical and administrative knowledge base.

SUPERVISORY RESPONSIBILITIES:
Manages the activities of Clinical Services team, including Care Managers, team leads and administrative staff.
Responsible for overall direction and evaluation of the clinical aspects of Care Management.
Responsibilities including interviewing, hiring, and training employees; planning, assigning, and directing work.

QUALIFICATIONS/ REQUIRMENTS:
• Minimum of an Associates or Bachelor’s degree in Nursing
• Infertility experience preferred.
• Experience managing staff preferred
• Experience in Utilization Management/Review preferred.

Application