Vacancy Description
We are so glad you are interested in joining Sutter Health!
**Organization:**
Sutter Health Alliance - Valley
**Position Overview:**
Supervises the overall operations of the Health Plan Clinical Operations. The ideal candidate will have experience working within a commercial health plan environment, preferably in California, with a strong understanding of DMHC (Department of Managed Health Care) and NCQA (National Committee for Quality Assurance) regulatory and accreditation requirements. Experience in Utilization Management, including medical necessity reviews, authorization processes, and coordination with providers and members, is highly desirable. Candidates should also have experience developing, reviewing, and maintaining health plan policies and medical policies, including the ability to interpret regulatory and legislative requirements and translate them into operationally sound policies and procedures. The successful candidate will possess a...
**Organization:**
Sutter Health Alliance - Valley
**Position Overview:**
Supervises the overall operations of the Health Plan Clinical Operations. The ideal candidate will have experience working within a commercial health plan environment, preferably in California, with a strong understanding of DMHC (Department of Managed Health Care) and NCQA (National Committee for Quality Assurance) regulatory and accreditation requirements. Experience in Utilization Management, including medical necessity reviews, authorization processes, and coordination with providers and members, is highly desirable. Candidates should also have experience developing, reviewing, and maintaining health plan policies and medical policies, including the ability to interpret regulatory and legislative requirements and translate them into operationally sound policies and procedures. The successful candidate will possess a...
Ready to Apply?
अभी आवेदन करें
Submit your application for Supervisor, Health Plan Clinical Operations, RN at Sutter Health
Apply for this Position