Contract Director, Iowa Medicaid Enterprise Surs
Health Care Excel (Central/Des Moines, Iowa)

This job posting has expired.

You may wish to try a search for Contract Director, Iowa Medicaid Enterprise SURS

Or visit the FlipDog home page
 

For over a quarter century, Health Care Excel (HCE) has objectively evaluated health-care quality, clinical appropriateness, and outcome assessments. The company design customized management solutions and develops appropriate educational programs to significantly improve the delivery of health services.

HCE is currently searching for a Contract Director in our Des Moines, IA office to oversee the daily management of our Iowa Medicaid Enterprise SURS contract. This opportunity will provide the right individual the opportunity to lead a group of highly trained individuals in the pursuit and recoupment of overpaid monies from the State of Iowa to providers; manage a group of well trained reviewers; and develop and coordinate cost-containment activities; surveillance and utilization review activities, and upon request from the state help review, clarify or revise the Iowa Administrative Code (IAC).

Key responsibilities for this position include:

Provides the oversight, leadership, management, and skills to effectively set and achieve SURS objectives on a daily basis. Make decisions based on contract requirements. Ensure SURS objectives are met as evidenced by contract monitoring reports. Ensure all monthly reports are delivered on time. Responsible for all staff. Oversee scheduling and provision of resources. Use data and reports such as Labor Utilization Report, number of reviews, and reviews conducted within timeframe to determine if current allocation of labor, materials, and time are adequate to ensure fulfillment of the program objectives. Responsible for developing and coordinating cost-containment activities, surveillance and utilization review activities, and suggesting changes to the Iowa Administrative Code (IAC). Initiate communication and correspondence with the State, other contractors, and partners to include presentation when requested. Create or approve correspondence and communication required by the contract. Coordinate with staff to respond to requests for information and referrals.

The ideal candidate will meet the following requirements:

Bachelor’s degree in health care administration, business administration, claims auditing, health care fraud and abuse, public health, nursing, health information administration, or related field, or the equivalent experience. An advanced degree preferred. Six years progressive experience in management for government or private sector health care entity. Previous experience in supervising utilization review and other cost-containment activities for a Medicaid program, other government health care program, or a large health care payer. Excellent leadership, management, organizational, and written and oral communication skills a must.