GENERAL SUMMARY
Responsible for identifying opportunities to enhance the quality of care and ensure cost effective outcomes by analyzing existing processes and providing recommendations to management to streamline operations based on existing standards and regulatory changes to the healthcare industry. Works cooperatively with senior leadership to identify opportunities for project development. Develops, initiates, implements, and monitors project outcomes.
ESSENTIAL RESPONSIBILITIES
- Identifies organizational opportunities for improvement based on upcoming legislation, accreditation requirements, and national best practices.
- Creates project proposals based on clinical needs, process improvement requirements, and cost indicators. Analyzes project potential and cost impact. Ensures projects are clinically sound where relevant. Presents project proposals to senior management for approval.
- Identifies and implements interventions to ensure project success. If necessary, identifies potential vendors to assist with interventions; oversees vendor contracting and performance.
- Communicates project results to senior management. Provides recommendations and action steps to drive maximum operational and financial effectiveness. Develops creative alternative solutions.
- Provides leadership in implementing and maintaining operational process improvements. Assists in the execution of audits to ensure projects are implemented as planned.
- Redesigns projects as needed based on modifications to national best practices, industry service delivery, or legislative changes.
- Creates and implements training and monitoring programs to ensure projects succeed.
- Presents successful projects at national conferences to establish Coventry as a leader of national best practices.
- Performs other duties as required.
Qualifications:
JOB SPECIFICATIONS
- Master’s degree or equivalent experience.
- Previous (5-7 years) project lead and comprehensive analytical experience required.
- Professional licensure preferred; Registered Nurse (RN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Mental Health Counselor (LMHC), Licensed Master Social Worker (LMSW), Licensed Professional Counselor (LPC), or Licensed Psychologist.
- Technical and/or operational expertise; demonstrated ability to conduct and interpret quantitative and qualitative analysis.
- Demonstrated ability to navigate among economic, clinical, research, and technology disciplines.
- Substantive knowledge of managed care operations.
- Strong written and verbal communication skills.
- Demonstrated consulting, project management, and leadership skills.
- Substantial knowledge of the health care business and delivery processes.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Professionals
Primary Location: Casselberry, FL, US
Organization: 51000 - MHNet Specialty Services, LLC
Schedule: Full-time
Job Posting: 2013-01-14 00:00:00.0
Job ID: 1310145