Director, Health Services

It's a great time to put the strength of Coventry behind your career! We are currently seeking a Health Services Director for our office in Richmond, VA. Develops, directs, and supervises the implementation of all departmental policies and procedures, goals and objectives. Assures staffing levels and staff competencies are appropriate to accomplish departmental duties and responsibilities productively and efficiently. Maintains working knowledge and communication of legislature, consortiums, and impending insurance law changes that may potentially affect utilization trends, practices, and standards at the plan or corporate level. Provides direction for the development of screening criteria, protocols, and benefit interpretations. Coordinates and participate in provider orientation/development/maintenance activities specific to utilization management. Assists in the identification and reporting of potential quality improvement issues. Responsible for assuring these issues are reported to the Quality Improvement Department. Participates in the budgetary process at the plan level, including preparation of a departmental budget and monitoring for adherence. Performs other duties as required.
REQUIREMENTS
Registered Nurse with a current state RN license. Bachelor’s degree or equivalent experience. Significant experience (usually 7+ years) in utilization management. Significant experience (usually 5+ years) clinical experience. Previous experience (usually 3+ years) managerial experience. To apply for this position, please visit our career center at http://careers.cvty.com, referencing job code # 725121.