Medicare Program Manager III

Under the direction of the Senior Program Manager of Geriatric Care, this position is primarily responsible for developing and implementing strategies to manage medical cost trend.  The individual would be responsible for implementing geriatric-focused systems of care to assist the Medicare Preferred Medical Groups (Medicare Advantage product) in their effort to improve clinical quality and resource utilization. They would be directly responsible for the oversight of medical management programs (as described above) of targeted groups in the MP population. These programs involve external interface with customers, providers or vendors in order to meet the program goals and may also have significant impact on internal departments.  As part of the group performance team, the Program Manager III will analyze network trends and performance and participates in the development and implementation group level performance improvement plans.


Education: 
Registered Nurse with current unrestricted Massachusetts state license
BSN: required, Master?s: Preferred
CCM: Desirable
Broad knowledge of project management is preferred.


Experience:
Minimum of five years of clinical nursing experience required, Medicare experience preferred.
Experience in medical case management/discharge planning/project/program management highly desirable
Experience and proficiency in business writing, and highest level of proficiency in presentation skills
Experience in the use of PC based systems is essential.