Vice President Clinical Care Services

Virginia Beach, VA
May 15, 2018
Oct 19, 2018
Full Time
Job Description: Responsible for the development, implementation, evaluation and innovative management of Optima's Clinical Care Services (CCS) programs, which are offered to commercial, Medicaid and Medicare members. Clinical Care Services includes direct Clinical Case Management, Behavioral Health, Disease Management, Utilization Management , Pharmacy Management , Health & Prevention, and Employee Assistance Program (EAP) services provided for all aspects of member care, as well as Quality Management services to include Quality Improvement initiatives, Credentials and Appeals, and is responsible for oversight of any delegated functions in these disciplines. Ensures ongoing compliance to accreditation standards for state, federal and regulatory agencies. Provides strategic and operational leadership to the CCS workforce in delivering innovative and excellent quality clinical support programs and services to Optima members with the goal of improving health every day. Accountable for managing the medical/loss ratio within Optima's vision, guiding principles and financial objectives. Education Level
Master's Level Degree

Required: Healthcare - 5 years, Managed Care - 5 years

Preferred: None, unless noted in the “Other” section below

None, unless noted in the “Other” section below

Required: Complex Problem Solving, Leadership, Social Perceptiveness

Preferred: None, unless noted in the “Other” section below

Sentara Healthcare's Optima Division is Currently Recruiting for a Vice President, Clinical Care Services.

Graduate of an accredited school of clinical practice such as professional nursing, counseling or social service. All licenses must be maintained in area of specialty.

Sentara Benefits:

Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace. For more information about our employee benefits, CLICK HERE!

Join our team, where we are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, growth!