Vice President- Clinical Programs
Vice President- Clinical Programs
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Salary Not Disclosed
1 Vacancy
Job Description
About Acrisure:
Acrisure is a global Fintech leader that combines the best of humans and high tech to offer multiple financial products and services to millions of businesses and individual clients. We connect clients to solutions that help them protect and grow what matters including Insurance Reinsurance Cyber Services Mortgage Origination and more.
Acrisure employs over 17000 entrepreneurial colleagues in 21 countries and have grown from $38 million to $4.3 billion in revenue in just over ten years. Our culture is defined by our entrepreneurial spirit and all that comes with it: innovation client centricity and an indomitable will to win.
Job Summary:
Providing quality service and accurate results supports our primary mission as a trusted adviser to our clients. As Vice President of Clinical Programs you will be working in a fast-growing company and work environment. Your valuable role and focus will include corporate oversight of all clinical programs including but not limited to Telephonic Case Management Utilization Review specialty services and various related medical topics. This role will also offer key support to the sales process implementation ongoing service deliverables customer retention and ensuring profitability. As a significant member of the Ascential leadership team you will continue to reinforce Ascentials mission of being a market leader and collaborative partner to ACPs current and prospective Customers.
Essential Functions
Oversee the development modification and implementation of clinical training programs as required for each clinical role benefit type and product
Collaborate with leadership to develop modify and implement Best Practice workflows specific to ACPs services and solutions
Collaborate with internal partners and vendors to develop clinical programs and solutions related to Pharmacy Ancillary and medical services
Develop clinical programs supporting non-WC claim benefit types i.e. Short Term Disability Long Term Disability FMLA Auto PIP General Liability etc.
Oversee and facilitate the development adoption and annual review and updates of Case Management Policies and Procedures
Collaborate with leadership to develop and implement Quality Assurance tools that measure compliance with Best Practice Client Specific Account Instructions New Programs and Regulatory workflows and program requirements
Develop quality improvement initiatives that apply continuous improvement methodologies targeting all team or individual improvement goals
Establish reporting and scorecard methodology to compare performance at a client team and individual level
Collaborate with leadership and clients to measure the effectiveness of training and quality assurance programs and identify gaps to improve services and delivery consistency
Facilitate or develop and present regular and CEU eligible training programs that benefit internal and external stakeholders
Implement ODG and other applicable Guidelines including training and quality management initiatives that reinforce ACPs Best Practice service standards and added value to ACPs clients and prospects
Participate as a key contributor in the audit process when requested by a state or URAC and provide all necessary documents concerning policies procedures training programs etc. as required for the audit
Participate in Datacare meetings as a clinical program expert to ensure the platform supports all best practice processes and reporting needs
Ensure compliance with SOC II Type II requirements and participate in scheduled audits as required
Interface with clients vendors and partners as required for clinical program development
All other duties and projects as assigned
Job Qualifications
Bachelor or higher degree in Nursing Business or another related field. The degree must be from an institution that is fully accredited by a nationally recognized educational accreditation organization
Current active and unrestricted Nursing licensure or certification in a state or territory of the United States that allows the professional to conduct an assessment independently as permitted within the scope of practice of the discipline
CCM or similar certification preferred
Job Requirements
A minimum of 10 years in a leadership role within the workers compensation industry
A minimum of 10 years experience in developing and presenting workers compensation clinical programs and other managed care services
A minimum of 5 years experience managing or building integrated disability management programs i.e. Short Term/Long Term Disability FMLA leaves etc.
Experience collaborating with executive leadership customers prospective customers
Ability to effectively network communicate and interface within all levels of an organization
MS proficiency: Word Excel PowerPoint & Outlook
Prior experience with Datacares case management system or similar system preferred
Must be proactive and able to prioritize multiple tasks to meet established deadlines
Must be able to work in a fast-paced service environment work well under pressure and can adapt to a constantly changing environment
Must possess organizational and planning skills excellent verbal and written communication skills and excellent interpersonal relationship skills
Other Duties:
Please note this job description is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of the employee for this job. Duties responsibilities and activities may change at any time with or without notice.
Physical Demands:
While performing the duties of this position the employee is frequently required to walk stand bend kneel stoop communicate reach and manipulate objects. The position requires mobility and frequent business travel that may include air travel and driving to client locations conference locations or other designated meeting sites of 25% at this time with the potential for expansion.
Duties involve moving materials weighing up to 10 pounds on a regular basis such as files books office equipment etc. and may infrequently require moving materials weighing up to 30 pounds. Manual dexterity and coordination are required while operating equipment such as computer keyboard calculator and standard office equipment.
Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
*References: CMSA Standards of Practice URAC
Reports to: President of ACP Status: Exempt
Acrisure is committed to employing a diverse workforce. All applicants will be considered foremploymentwithout attention to race color religion age sex sexual orientation gender identity national origin veteran or disability status. California residents can learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy available at Executive Search Firms & Staffing Agencies: Acrisure does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. All unsolicited resumes will be considered Acrisures property and Acrisure will not be obligated to pay a referral fee. This includes resumes submitted directly to Hiring Managers without contacting Acrisures Human Resources Talent Department.
Required Experience:
Chief
Employment Type
Full-Time
