R.A. Wylan & Co. Inc.,
Career Center

Medical Management (RN) Senior Director - CCM Medicare/ Medicaid Exp.

Location: Atlanta, GA
Job Type: Direct Hire
Salary: $115,000.00 - $145,000.00
Date: 3/9/2018
Job ID: 02577866
Job Description
NEWLY CREATED POSITION! Are you a “Trail Blazer”? Are you a RN (BSN) with 7+ years of clinical nursing, quality improvement, and management experience in a managed care setting?  Are you a Certified Case Manager (CCM)? This is preferred and would be a feather in your cap! Do you have a proven track record of management/ leadership?
Is this sounding like you? Read further!
Our client really needs candidates to have the following:
  • Familiarity with Commercial, Medicare and Medicaid is a plus.
  • Program development and knowledge of NCQA and CMS standards is highly desired.
This position reports to the VP of Medical Management.
Our client is offering relocation.
Salary is based on experience. Salary starts at $115,000 and goes up quite considerably from here AND you are also eligible for a 20 % annual performance bonus.
You should have experience DOING the following:
·  Develop department objectives and organize activities to achieve objectives.
·  Evaluate and implement changes to medical service functions and performance in relation to company mission, philosophy objectives and policies for multiple health plans
·  Participate as a subject matter expert in implementation of new health plans
·  Manage budget and forecast for strategic planning and key initiatives
·  Coordinate with operating departments on research and implementation of best practices
·  Responsible for the statistical analysis of programs related to utilization and case management
·  Participate in NCQA, State, and/or other accreditations of the Plan
·  Organize and present new concepts, programs and tools to staff and health plans d
·  Serve as a mentor for multiple plans and staff
·  Develop communication plans with external providers such as hospitals and State agencies as required to facilitate plan goals and objectives
·  Coordinate with Medical Director to educate and communicate expectations with providers.
Our client offers a full, comprehensive benefits plan and is an advocate for promoting from within.
Outstanding Benefits!
For your health
Our client pays for most of these benefits, but those not covered can be paid with pre-tax payroll deductions.
  • Health, dental and vision insurance
  • Flexible spending accounts (includes health care, dependent care, and mass transit reimbursement)
  • Short- and long-term disability insurance
  • Basic life insurance
  • Supplemental AD&D
  • Supplemental life insurance
  • Wellness program
Succeeding together
They want you to do more than just plan for retirement, they want to share their success with you.
  • 401(k) retirement with company match
  • Employee stock purchase plan
Finding a balance
They provide a variety of benefits that let you focus on what’s most important.
  • Vacation, Personal and Sick time
  • Paid Company Holidays
  • Employee Assistance Program (EAP)
  • Training and Learning Opportunities
  • Accelerated Leadership Development Programs
  • Tuition Reimbursement/Educational Assistance
  • Service Awards
  • On-site fitness center or discount at local fitness centers (most locations)
  • Discounts for select local and national products and services, including cell phones, computers and more
Should you meet the requirements of this job, please email your resume to us along with the best days and times to reach you.  If you are selected, we will coach you through every step of the process.