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Director of Health Plan Quality and Utilization / 55278

CPS Recruitment is seeking a Director of Health Plan Quality and Utilization for an award-winning company providing community based care. This position offers flexibility with some monthly requirements in Syracuse, NY but otherwise allows for work at some of their satellite offices. This well establish and industry leading organization is currently experiencing huge growth and offering an opportunity for advancement.

This organization offers outstanding benefits and supports professional growth and personal wellness by providing:

  • Competitive Salary: $80-$90K
  • Outstanding benefits
  • Generous PTO starting in your first year
  • State of the art facility
  • Room for career advancement

As the Director of Health Plan Quality and Utilization, you will oversee the implementation of managed care plans.

  • Develop Managed Long Term Care Plans and Medicare Advantage Plans
  • Review MLTC and MA programs and oversee the implementation of program initiatives
  • Evaluate HEDIS improvement action plans and review processes
  • Supervise and monitor staff and management regarding care planning

Background Profile for the Director of Health Plan Quality and Utilization:

  • Current NY State licensed Registered Nurse
  • Bachelor’s Degree in Nursing
  • Previous experience with QA/QI
  • Experience working with NCQA and HEDIS preferred
  • Strong technical skills with MS Office and other computer applications
  • Strong project management skills and exceptional communication skills

For immediate consideration for this Director of Health Plan Quality and Utilization role, please submit a resume in WORD to healthcare@cpsrecruiter.com

If this Director of Health Plan Quality and Utilization position is not a good fit for you but better for someone you know, feel free to forward the information. We compensate up to $500 for referrals that are hired on by our clients.

CPS Recruitment is an EOE

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Start Date:
Pay Rate:
$80,000 - 90,000/year
Healthcare - Clinical
Syracuse, NY 13204
Job Type:
Direct Hire
Job ID: