Vice President Care Management Business Line

CNSI and Kepro are now Acentra Health!  Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. 

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. 

Acentra is looking for a Vice President Care Management Business Line to join our growing team.

Job Summary:

The Business Line Vice President is Acentra Health’s clinical and operational advisor for our Care Management line of business. This position serves as Acentra Health’s subject matter expert on clinical operations, quality initiatives, and the interface with Acentra Health’s technology platforms. The Vice President will serve as the liaison between the operations team, corporate functions and IT for system enhancements, configuration, and triage. This position collaborates with business development on potential new business and provides support to the clinical operations team during new business implementations and on special projects.

Job Responsibilities:

• Clinical subject matter expert for Acentra Health’s Care Management programs – including the development and fine tuning of operational and system best practices.
• Key stakeholder in FPA activities, including working on cross functional teams to identify opportunities for operational improvements either through workflow analysis, system recommendations or automation initiatives within the company.
• Responsible for creating clinical operational training to support Acentra Health’s Care Management book of business – including new and existing clients.  Identifies training needs based upon best practices and audit findings.
• Lead continuous quality improvement activities by partnering with quality leaders within Care Management and identifying opportunities for operational efficiencies.
• Serves as the clinical subject matter expert on Acentra Health’s proprietary system to represent the Care Management operational configuration on new system rollouts and triage.
• Providers operational leadership across programs within the solution line, as needed.
• Leads standardizing elements of Care Management operations across all contracts.
• Collaborates with Acentra Health’s business development team on new client opportunities.  Requirements include acting as subject matter expert on Utilization Management capabilities, evaluating business opportunity scope and assisting Operations team in developing operational business response.

Requirements

Required Qualifications/Experience

• Active, unrestricted Licensed Registered Nurse.
• Bachelor’s Degree.
• Significant experience managing clinical care management (UM and CM) operations, at least 3+ years of clinical management experience.      
• Excellent verbal and written communication skills essential.
• Current working knowledge of utilization management, case management, and managed care.
• Customer-focused, results-oriented and capable of building and maintaining relationships with internal and external customers. 
• Organizational skills, ability to plan and prioritize multiple assignments essential.
• Current Interqual and Milliman criteria knowledge.
• Skill in examining and re-examining operations and procedures, formulating policy, and developing and implementing new strategies and procedures.
• Knowledge of U.S. healthcare industry.
• Experience in using systems that support Utilization and Case Management processing.
• Demonstrated expertise in managing differing customer needs.
• Understanding of URAC standards and processes.
• Ability to participate as a team member fostering collaborative decision-making among leadership, committees, teams or work groups of diverse composition.
• Computer proficiency in Microsoft Office applications and other software programs essential to perform job functions.
• Ability to develop, plan, and implement short-and long-range goals. 
• Skill in employee development and performance management.
• Ability to provide technical guidance and leadership to management team.
• Advanced verbal and written communication skills and the ability to work with a wide range of constituencies in a diverse community.

Preferred Qualifications/Experience:

• Or equivalent to a Bachelor's Degree directly applicable experience in nursing, healthcare administration or related area is preferred.
• 3 years of utilization review experience preferred.

Benefits

Why us? 

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes. 

We do this through our people. 

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career. 

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.  

Compensation 

The pay range for this position is $167,100-$208,900

“Based on our compensation program, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.” 

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

EOE AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.