Description
UCLA HEALTH
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Description
We are seeking a highly skilled and dynamic Director of
Clinical Services to lead the development, evaluation, and implementation of
multiple clinical programs and medical services with an emphasis on optimizing
Utilization Management for the Faculty Practice Group (FPG) Management Services
Organization (MSO). Reporting to Chief
Medical Officer of Faculty Practice Group and Medical Group, this role is pivotal in ensuring the
delivery of program functionalities in all aspects of Utilization Management
and its integration with other patient facing programs within the MSO. You will oversee and direct key initiatives,
ensuring that MSO members enrolled in various health plans receive
high-quality, integrated care.
You will:
- Oversee
the development and execution of multiple UM processes and workflows, while continuously
identifying and evaluating areas for improvement and potential innovations to
be implemented - Oversee
the development and execution of needed points of integration aimed at
enhancing healthcare delivery for MSO members. - Ensure
seamless integration of various clinical functions with Utilization
Management, such as Case Management, Quality Improvement, Credentialing,
and Health Plan Relations to improve overall healthcare services and
control healthcare costs. - Collaborate
with internal and external stakeholders to ensure cohesive and effective
program delivery, while supporting value-based care initiatives. - Build
and maintain strong relationships with key stakeholders, including
members, health plans, and clinical teams, to ensure the effective
execution of health programs and services. - Direct and mentor staff members, ensuring clear
communication, effective teamwork, and high-performance standards.
Salary Range: $144,400 – $341,800/annually
Qualifications
We’re seeking an experienced leader with:
- A Registered Nurse License, Advanced Practice
Provider (Nurse Practitioner or Physicians’ Assistant), or equivalent - Bachelor’s degree in relevant discipline,
required - Master’s degree in relevant discipline, highly
desired - 3-5 years of experience in a clinical capacity
(RN, APP, etc.), required - 3-5 years of executive leadership experience with
a focus on Utilization Management for a medical group, IPA, or Health Plan, required - In-depth understanding of managed care, MSO
functions, and population health services, required - Experience and successful achievement of
healthcare MSO certification and recognition programs - Strong communication skills with all levels of
staff and stakeholders - Ability to navigate and perform duties within a
complex, matrixed organization - Leadership capabilities that demonstrate
openness to change and the ability to implement innovative programs that align
with strategic initiatives - Exceptional interpersonal, written, and verbal
communication skills - Proficiency in Microsoft Office applications
(Word, Excel, PowerPoint) - Ability to function independently with sound
judgement in decision-making and take initiative when needed while
appropriately soliciting input or advice