Executive Lead, Clinical Care Management

Highmark Health / AHN; Pittsburgh (Allegheny County); Vor Ort; USD 120.000 - 160.000; Vollzeit

Zusammenfassung

Allegheny Health Network seeks a senior leader to oversee clinical care management strategy and operations, ensuring high-quality patient care through standardized processes and data-driven performance metrics.

The role directs policy development, workflow standardization, and collaboration across system leadership to drive utilization management, readmission reduction, and compliance with HIPAA and privacy policies.

Qualifikationen

• Bachelor’s degree in Nursing, Business, Health Care Management or related field.
• 7 years of management experience in healthcare insurance or healthcare industry with a nursing background, preferably utilization management and related clinical operations.
• Master’s degree.

Aufgaben

• Leads the development and oversees the execution of policies and procedures.
• Directs the standardization of CM policies, practices workflow and data reporting within the system.
• Accustomed to managing through KPIs and provide education/driving towards improvement.
• Establishes strategic, tactical and financial plans to optimize the efficacy of clinical operations and utilization management.
• Leads the development of effective communication with internal and external customers to coordinate and adequately address patient care needs.

Ausbildung

Bachelor’s degree in Nursing, Business, Health Care Management or related field

Master’s degree

Jobbeschreibung

Allegheny Health Network seeks a senior leader to oversee clinical care management strategy and operations, ensuring high-quality patient care through standardized processes and data-driven performance metrics.

The role directs policy development, workflow standardization, and collaboration across system leadership to drive utilization management, readmission reduction, and compliance with HIPAA and privacy policies.