This senior-level position is responsible for administering and coordinating all responsibilities associated with the contract for the operation. Primarily responsible for daily operations of the program with hands-on oversight for all operational areas.
Assure timely compliance with all contract responsibilities is responsible for overall planning, direction and control to achieve operating and financial goals. Establishes action plans, timetables and outcome measurements; report analysis and action, provider relations, obtains and allocates resources; and reviews progress of the program in order to meet contract deliverables.
Serves as the liaison to the Department, providing immediate and excellent customer service to the Program Manager and Administration staff.
10 years’ of progressive operational leadership of a public and/or private sector healthcare entity with at least five years in a position of direct operational authority for an entire operation.
5 years’ of management experience in medical utilization review.
TRICARE/DOD/DHA experience strongly preferred.
Significant experience managing contract operations including contract administration functions.
Requires advanced knowledge of UR, QM, CM and health field/business requirements and interrelations.
Skill in examining and re-examining operations and procedures, formulating policy, and developing and implementing new strategies and procedures.
Ability to analyze resources and environment appropriate to the scope of responsibility and design a course of action consistent with KEPRO's mission and strategic plan.
Demonstrated achievement in P&L management, operational process engineering, remote operations management and new business development support.
Ability to successfully manage change and growth.
Knowledge of business development, strategic planning, tactical implementation and creation of business partnerships.
Demonstrated expertise in managing differing customer needs.
Since 1985, KEPRO has helped over 1 billion members lead healthier lives through clinical expertise, integrity and compassion. Our values are promises we keep every day. And why we keep growing with our clients.
Mission & Vision
KEPRO's Mission Statement
To advance the quality and efficiency of health care through integrated care management solutions tailored to the needs of our c...ustomers and stakeholders.
KEPRO's Vision Statement
To be an industry leader known for our exceptional suite of products and services, our highly skilled professionals, and delivery of credible, measurable results to our customers and stakeholders.
KEEP YOUR MEMBERS HEALTHY AND YOUR ROI ROBUST.
Learn more about our fully customizable services.
The only constant in healthcare today is change. Our flexible, nimble and customizable programs help guarantee the best outcomes. For your members, your organization and your own peace of mind.
As their health needs change, members require different services and solutions that mirror their needs. From assessing medical necessity to managing costly conditions, KEPRO's unique holistic and customizable approach ensures that your members get the care they need. When and where they need it. And you can access real time reports online, to see the big picture and analyze every small detail.
Let us help you find the right solutions today.
• Case Management
• Specialty Case Management
• Utilization Management
• Chronic Care Management
• KEPRO Wellness
• Quality Oversight
• Independent Medical Reviews
• Maternity Management
KEPRO Headquarters 777 East Park Drive Harrisburg, PA 17111 Toll-free:800.222.0771 Phone:717.564.8288 Fax:717.564.3862