Description

About iMPROve Health

Come join the iMPROve Health team! iMPROve Health is Michigan’s Medicare-designated Quality Improvement Organization. We are both a Cool Place to Work (Crain’s Detroit Business) for the last 4 years and one of the Best Places to Work in Healthcare as judged by Modern Healthcare. As a nonprofit organization, we have more than 40 years’ experience improving healthcare across the continuum of care using evidence-based and data-driven logic. iMPROve Health provides medical consulting and review, as well as data analysis to federal agencies, state Medicaid and public health organizations, healthcare facilities, private health plans and other third-party payers. We also have extensive experience completing thoughtful and impartial utilization review, dispute resolution and peer reviews. Our goal is simple – to help healthcare get better!

This position is 100% remote and provides the opportunity to work virtually with team members from anywhere within the United States. We pride ourselves on providing a great work/life balance for employees, while also providing the ability to promote their career development and gain new skills through employee education opportunities.

iMPROve Health is committed to improving the quality, safety, and efficiency of healthcare. Although we do not see patients, we are healthcare professionals (including physicians and nurses) and consultants who work with healthcare providers to promote the adoption and use of evidence-based best practices and processes to achieve our healthcare quality goals. Our services offer our clients and partners access to a proven, impartial, connected resource that understands the intricacies of healthcare. It is our #1 priority to provide thoughtful evidence-based strategies and solutions that help them achieve their healthcare quality improvement goals and outcomes.

iMPROve Health is an equal employment opportunity employer.

SUMMARY:

The managing director of State Agency IDR/IIDR Review Services is responsible for the management of all assigned IDR/IIDR contracts, projects, deliverables and assigned staff. Active participant in all RFP development and contract negotiations. Manages day to day operational activities of assigned team, with oversight over all assigned staff. Ensures operational activities are delivered in accordance with performance and financial standards. Represents the organization to relevant stakeholders as needed.

ESSENTIAL DUTIES:

Manages day-to-day operations of project/departmental contract activities and staffAssesses barriers that may impede project work.
Maintains communication with the team.
Shares and applies knowledge gained from relevant training and experience.
Implements policies/procedures to organize and improve operations.
Understand and execute duties with minimal direction.
Ability to cope independently with new, unexpected, and complex situations.
Ensures the contract or department deliverables are successfully implementedCollaborates with leadership to ensure operational plans meet the contract deliverables.
Develops and monitors detailed work plans.
Notifies supervisor of any problems or potential issues with contracts.
Strives to provide excellent customer service.
Committed to and performs quality work contributing to project team’s success.
Discusses the budget monthly with leadership staff to identify variances (as budget data is available).
Assesses current resources and identifies needs to meet contract deliverables.
Effectively sets goals and establishes priorities for the department.
Enhances teamwork within the department by fostering a collaborative environment where team members can work and think together.
Works cooperatively with others to achieve established goals.
Identifies and implements interventions to increase operational efficiencies, communication and teamwork.
Handles high levels of stress and deals with difficult situations as they arise to ensure the department functions smoothly and within contract requirements.
Adheres to all relevant compliance regulations (HIPAA, FISMA, URAC, CMS).
Other duties as assigned.

Requirements

EDUCATION AND/OR EXPERIENCE:

BSN required, MSN preferred. RN with current unrestricted license in one or more states in the United States required.
5-7 years in long-term care operations and/or state survey agency management required
5 years with managing a team and contract deliverables required
Licensed Nursing Home Administrator preferred
Working knowledge of Informal Dispute Resolution (IDR) and Independent Informal Dispute Resolution (IIDR) services preferred
Strong verbal and written communication skills
Quality improvement experience preferred
Excellent organizational, project management, and customer service skills required
Demonstrated proficiency in reading and interpreting federal/state contracts and regulations preferred