Director Clinical Strategy & Care Model

Job ID: BDP-1019485 Description:

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants.We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

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Job Purpose:

This position is responsible for designing the clinical aspects of the division's Value Based Care (VBCM) program. This position provides strategic planning, decision making, and direction of the Clinical Practice Liaison program that supports clinical practice transformation activities at provider organizations and collaborates with community stakeholders in the design and provision of educational programs that support practice transformation. The position facilitates provider organizations participation with the local Health Information Exchange to support objective quality outcome reporting. This position serves as primary resource to assist marketing in presentation of the VBCM program to ASO accounts to interpret information and recommend program enhancements based on client feedback. In addition, this position directs the operations of the quality improvement and accreditation programs.

Required Job Qualifications:

  • Bachelor Degree in Nursing or business related field.
  • 8 years Managed Care, Utilization Management and/or Case Management experience.
  • 4 years supervisory/management experience in the health care field and demonstrated effective leadership abilities.
  • 3 years clinical experience.
  • Knowledge of insurance and health database systems; and accreditation standards for bodies including but not limited to NCQA or URAC.
  • Experience in project management and program development/implementation
  • Clear and concise verbal and written communication skills.
  • Experience with preparing presentations and presenting to executives.

Preferred Job Qualifications:

  • Master's Degree.
  • Registered Nurse (RN), with current, unrestricted license to practice in state of operations.
  • Certification in Case Management or Utilization Management.
  • Experience with quality processes.

Requirements: Expertise Other Job Type Full-Time Regular Location OK - Tulsa

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