Job Description
Location: Mockingbird Towers 4th FLR
PCHP - Parkland Community Health Plan
Remote
PRIMARY PURPOSE
Oversees medical coordination required for effective utilization and quality management of the health plan network. Supports the clinical activities of PCHP Utilization Management, Quality Management, Clinical Policy, Technology Assessment, Credentialing, Population Health and Fraud, Waste and Abuse Functions to assure comprehensive, high quality health care to plan members in accordance with managed care and PCHP policies. Monitors clinical care needed to produce optimal health outcomes and cost-effective care.
MINIMUM SPECIFICATIONS
Education
PCHP - Parkland Community Health Plan
Remote
PRIMARY PURPOSE
Oversees medical coordination required for effective utilization and quality management of the health plan network. Supports the clinical activities of PCHP Utilization Management, Quality Management, Clinical Policy, Technology Assessment, Credentialing, Population Health and Fraud, Waste and Abuse Functions to assure comprehensive, high quality health care to plan members in accordance with managed care and PCHP policies. Monitors clinical care needed to produce optimal health outcomes and cost-effective care.
MINIMUM SPECIFICATIONS
Education
- Must have successfully completed an Accreditation Council for Graduate Medical Education (ACGME) or American Medical Association (AMA) approved residency in an appropriate specialty to the PCHP population.
- Master's degree in business administration, healthc...