At least 12 years experience in health care, and at least 10 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), and progressive experience in clinical operations, or equivalent combination of relevant education and experience.
At least 7 years health care management/leadership experience.
Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
Experience working within applicable state, federal, and third party regulations.
Operational and process improvement experience.
Strong interpersonal skills.
Strong leadership capabilities, and ability to initiate and maintain cross-team relationships and manage change.
Demonstrated experience meeting quality accreditation standards (National Committee for Quality Assurance (NCQA)/Healthcare Effectiveness Data Information Set (HEDIS)/Medicare STARS).
Excellent organizational and time-management skills.
Flexibility in the work environment and willingness and ability to adapt to changing organizational needs.
Excellent verbal and written communication skills.
Microsoft Office suite (including Excel), and applicable software program(s) proficiency.

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