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Description of VP Quality Large NYC MLTCP/FIDA Plan

Position Category Facility Location
VP Quality Large NYC MLTCP/FIDA Plan Quality Health Insurance Company New York City NY
DESCRIPTION: We have been retained by a large, prominent metropolitan NYC healthcare system, offering a full spectrum of care, to locate an individual to serve as Vice President, Quality for their large multi-site MLTCP/FIDA Program. He/she will be responsible for development, implementation, integration and management of all quality assurance/performance improvement activities within their Medicaid and Medicare programs. This includes overseeing the Grievance and Appeals Process, providing high level support to plan leadership and middle management in the development and implementation of a quality driven approach to care management and representing the plan’s quality program to external and regulatory agencies. This key position reports to the Executive Vice President of the organization and works closely with the Chief Medical Officer.

EXPERIENCE: The successful candidate will have a Bachelor’s degree in Nursing or another health related field. A Masters degree in a health related or business field is preferred. He/she should have a proven progressive management track record in Quality Assurance/ Performance Improvement coupled with experience in Utilization Review, Discharge Planning, Medicare and Medicaid Audits in a Medicare Managed Care Program, Managed Long Term Care Program, PACE or Certified Home Care agency. He/she shall have strong analytic and communication skills and be proactive and visionary in evaluating member outcomes and developing best practices to bring the organization to a higher level. He/she shall have proficiency in MS Word, Excel, PowerPoint and Crystal Report writing coupled with strong knowledge of ICD-9, ICD-10 and CPT coding. Knowledge of HEDIS is also desired! Our client offers an excellent salary and most competitive benefits package including a substantial employed paid TDA. All inquiries are held in strict confidence. If you or someone you know might be interested in further information about this positions please contact
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