Need a helping hand? Call our office
helpline for assistance - 888-258-7621
Need a helping hand? Call our office
helpline for assistance - 888-258-7621
Quality Care Partners is strongly committed to improving and maintaining the health of the people we serve by providing excellence in medical management and the premier provider network in Southeastern Ohio. Our mission is to be the focal point of an integrated health care delivery system that promotes cost-effective, quality healthcare through contractual relationships.
We offer an attractive compensation package, including excellent benefits, and ample opportunity for professional development. If you are interested in applying for a job opportunity at QCP, please email your resume to info@qualitycarepartners.com, or fax your resume to 740-455-8817 for consideration.
Click the link(s) below to view requirements and description of the job.
Role expectations for the Director of Medical Management include: effectively directing the Medical Management program to provide strategy and leadership oversight of the Medical Management Program. Actively promotes an organizational culture committed to high quality customer service to clients and their families, physicians and other members of the health care delivery system. Works collaboratively with contracting departments’ provider relations and administrators for the development and maintenance of clinically appropriate, cost effective care management processes. Develops policies and procedures to improve efficiency and ensure a focus on outcomes. Ensures that Quality Care Partners is in compliance with Ohio Department of Insurance and Department of Labor Regulations/standards by implementing applicable policies and procedures. Communicates the Medical Management Department Goals and Objectives to the team and plans activities and strategy. Works closely with QCP Compliance department and administration to identify contractual needs in specific areas. Stays abreast of industry trends and new developments to continuously improve the services provided by QCP. Participates in and seeks educational forums for self and staff. Participates in applicable professional organizations.
Download Full PostingRole expectations include: Answer calls from enrollees and provider offices to pre-certify medical procedures and testing, Obtain and review additional medical information & benefit design, Direct enrollees to appropriate resources, Deliver pre-certifications to appropriate nurse and Assist team with other clerical duties.
Download Full PostingREPORTS TO: Onsite Practice Administrator in consultation with the Director of Clinical Integration
Download Full PostingQuality Care Partners Is An Equal Opportunity Employer