KEPRO is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. KEPRO is seeking resumes for a highly experienced professional.

Program Lead

Summary Description

Under general supervision of the VP of Utilization management and in collaboration with the administrative team, the Project Lead oversees the department responsible for Utilization Management in accordance with the goals of the North Dakota DHS QIO Program.  This individual will manage all scopes of work related to the North Dakota QIO Program including training and managing all UM staff.  This RN professional also represents Kepro by participating on committees, task forces, work groups, and multidisciplinary teams, maintaining professional relationships with the provider community and external customers, and identifying opportunities for improvement.

Accountabilities

• Serve as primary point of contact between KEPRO and client.


• Oversee, coordinate, and monitor all Clinical team activities related to programs assigned.


• Ensure adequate staffing and contractual service levels are adhered to by implementing and monitoring clinical staff productivity and performance indicators. Maintains effective team member relations.


• Leads team members in improving skills, creativity, and problem solving.


• Work with management team and Executive management to develop and enhance the operational structure including skill set requirements, gap analysis, and training using workforce planning.


• Responsible for monitoring performance and compliance with Contract requirements and Deliverables.


• Ensure proper staffing levels throughout the term of the Contract.


• Collaborate with the Director of Quality to continuously improve Contractor’s performance and service provided to the Department.


• Manages and completes assigned work plan objectives and projects on a timely basis.


• Participates in the development of policies and oversees clinical staff activities to ensure compliance with regulatory and accrediting standards.


• Communicate with a variety of stakeholders that have varying levels of knowledge regarding the ND QIO Program.


• Provides reports of compliance and oversight and reporting of contract required Service Levels.


• Maintain a positive relationship with our client, by developing ongoing communication and collaborative approach to delivery expectations.


• Creatively solve problems using industry best practice, data driven analysis and recommendations.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.

Qualifications

• The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.


• Bachelor’s Degree in Nursing or Associates Degree in Nursing with bachelor’s degree in a related field required


• Active non-restricted RN license required.


• Reside in the state of North Dakota, strongly preferred.

Knowledge, Skills, Abilities

• Demonstrated proficiency in MS Office applications.


• Experience with implementation of new programs, projects, systems, and/or tools.


• Ability to maintain a positive attitude and contribute both as an individual and a team member to achieve the goals of the department.


• Ability to professionally respond to change and handle multiple and changing priorities with sometimes conflicting deadlines.


• Knowledge and willingness to become a subject matter and thought leader for designated program(s).


• Knowledge of NCQA/URAC standards strongly preferred.

Experience

• 5+ years of clinical experience required.


• 5+ years staff/workload management experience required.


• Experience with State Medicaid programs, required.


• Experience in utilization management required.


• Experience working with Vulnerable Populations, strongly preferred. 
  

Mental and Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state

KEPRO offers challenging careers, excellent benefits and opportunities for advancement.  For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please.  Visit our website at www.KEPRO.com for more information on the KEPRO Family of Companies.    

EOE AA M/F/Vet/Disability 

KEPRO is an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)

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