Amplifon USA

  • Director of Clinical Programs (Audiologist) Contractor

    Job Location US-MN-Minneapolis
    Posted Date 8 months ago(1/2/2019 6:16 AM)
    Job ID
    2018-3143
  • Overview

    The Amplifon Hearing Health Care Director of Clinical Program leads all clinical compliance functions, utilization functions, and support delegation oversight.  They partner with hearing health care providers and health plans to provide care delivery that is preventive, convenient, coordinated, and that results in improved clinical outcomes for Amplifon Hearing Health Care’s customers.  

     

    Responsibilities

    Management:

    • Develop and maintain standards of performance and ensure network adherence to practice guidelines and care management protocols
    • Develop and maintain clinical program polices, workflows, and monitor outcomes
    • Lead departmental quality improvement activities to improve program performance
    • Co-Chair the Quality Improvement Steering Committee (QISC)

    Production:

    • Prepare data and written reports or materials for meetings and as required or requested by leadership
    • Actively participates in internal and external audits
    • Oversee all appeal, grievances, and clinical member and provider complaints
    • Oversee all denials
    • Oversee clinical UM policy
    • Oversee clinical staff clinical UM decisions
    • Oversee clinical staff UM decisions
    • Oversee team educations outreach to contracted providers
    • Oversee clinical requirements of the AHP credentialing program
    • Proactive clinical support for all audits.

     

    Maintain:

     

    • Support compliant turnaround times
    • Support AHHC Model of Care
    • Clinical support for AHHC team

    Qualifications

    • Education/Licensure: Audiologist, ENT MD/DO.
    • Knowledge of the health insurance industry, products/services, internal operations and related processing systems, and regulatory requirements
    • Five years managerial experience
    • Experience developing and maintaining clinical policies and procedures, and work process improvements
    • A proven track record of building and fostering relationships at all levels of a matrixed organization

    Required proficiency with tools:

    • Highly organized skills required.

    We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. If selected for an interview, please advise our Human Resources team if you require accommodation during the interview and assessment process and we will work with you to meet your accessibility needs.

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