Executive Director (RN)

Company: KEPRO (The Keystone Peer Review Organization), Inc
Location: Columbus
Posted on: January 26, 2023

Job Description:

Executive Director (RN)

• Are you an experienced Executive Director looking for a new challenge?
• Do you value care management and quality improvement?
• Are you motivated, energetic, and excited to become part of the Kepro team? If so, you might be our next new team member! Who we need: The Executive Director is responsible for planning, directing and managing the resources of the operational team(s) of the Indiana Utilization Management (UM) Contract to ensure contract compliance as well as operating and financial goals. Individuals within this role play an important role within the company as a subject matter expert within their contract or solution area and provide leadership to large complex contracts and their team(s). Executive Directors work closely with key stakeholders within the organization to create solutions and generate growth and development. Why us? Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. People Focused. Mission Driven. Shape the future of healthcare with us. We are mission driven to improve lives through healthcare quality and clinical expertise. We do this through our people. At Kepro, you can do meaningful work that makes a real difference for the lives of individuals across the country. We are an organization that cares deeply about our employees and we provide the training and support to do the best work of your career. Benefits are a key component of your rewards package at Kepro. These benefits are designed to provide you and your family additional protection, security, and support for both your career and your life away from work. They are comprehensive and fit a variety of needs and situations. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more. What you'll do:
  • Oversight over services such as: prior authorizations, special reviews, focused reviews, medical record reviews of Managed Care prior authorizations/claims, community behavioral health service reviews, psychiatric hospital admission reviews, provider appeals of Managed Care Entity denials, home health and private duty nursing authorization requests. NOTE**This list is not all-inclusive
    • Facilitate and coordinate the activities of multiple work groups, teams or operational units. Direct oversight of all management level staff.
    • Ensure headcount is rightsized to the operation, considering attrition rates and contractual requirements, while meeting workload and financial targets.
    • Develop and maintain an operational infrastructure that includes employee skill set requirements, gap analysis, performance management, and training plans. Create and implement effective retention plans in conjunction with Human Resources.
    • Ensure compliance with contractual requirements within the operation by monitoring critical indicators, deliverables and budgets.
    • Establish and maintain effective customer rapport and mutually beneficial business relationships.
    • Draw on expertise of staff and others for business implementations. Assemble and deploy the resources necessary to ensure success.
    • Develop regional long-term and short-term operating and financial goals including budgets and forecasts to ensure effective operations and optimum profitability.
    • Work with management team to develop and enhance the operational structure including skill set requirements, gap analysis and training plans through workforce analysis.
    • Participate in cross-regional activities to enhance operating efficiencies and serve as a Subject Matter Expert (SME).
    • Support and participate in strategic planning and execution to enhance growth, profitability, productivity, and efficiency throughout the company's operations. Collaborate with leadership in the development of new and enhanced policies and procedures.
    • Assist in the implementation of contracting strategies and programs that reduce cost as well as maximize revenue streams. Monitor the technical performance (which includes adherence to schedule and cost requirements), resource planning, and evaluations of the services provided by KEPRO.
    • Provide advice and assistance in the planning, implementation and evaluation of modifications to new and existing operations, systems, and procedures.
    • Represent the organization at internal, local, state, and national meetings. The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time. What you'll need: Required Qualifications
      • Bachelor's or Master's degree in administration or in any of the health related fields with the relevant experience and capability to oversee the contract.
      • Active, unrestricted Licensed RN in Ohio
      • Leadership experience in clinical setting
      • 3-5 years of utilization management preferred. Knowledge, Skills, Abilities
        • Ability to work within KEPRO's decision-making and organizational structure.
        • Skill in examining and re-examining operations and procedures, formulating policy, and developing and implementing new strategies and procedures.
        • Knowledge of healthcare industry; preferably with experience in both public and private sector.
        • Ability to analyze and interpret financial and operational data and prepare business reports, projections, and recommendations.
        • Ability to develop, plan, and implement short-and long-range goals.
        • Skill in employee development and performance management.
        • Ability to successfully manage change and growth.
        • Ability to provide technical guidance and leadership to management team.
        • Advanced verbal and written communication skills and the ability to work with a wide range of constituencies in a diverse community.
        • Knowledge of quality improvement methodologies.
        • Knowledge of business development, strategic planning and tactical implementation.
        • Ability to participate as a team member fostering collaborative decision- making. Experience
          • Significant experience managing contract operations including contract administration functions.
          • Recent experience in public and/or private sector healthcare providing services to government programs preferred.
          • Five to seven years of progressive operational leadership in a public and/or private sector healthcare entity with at least three to five years in a position of direct operational accountability for multiple departments or units. Thank You! We know your time is valuable and we thank you in advance for applying for this position. Due to the high volume of applicants we receive, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Kepro and invite you to apply to future openings that may be of interest. Best of luck in your search! - The Kepro Talent Acquisition Team Mental and Physical Requirements The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state. EOE AA M/F/Vet/Disability Kepro is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Keywords: KEPRO (The Keystone Peer Review Organization), Inc, Columbus , Executive Director (RN), Executive , Columbus, Ohio