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Assistant Vice President of Clinical Operations
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- This role oversees the clinical and non-clinical staff within the District of Columbia (Maryland) Medicaid areas of utilization management, care management and process improvement.
- Ensures that utilization management and case management programs timeframes are in compliance with local, federal and NCQA standards.
- Oversees the organization's utilization management function, pre-certification functions, and management of pharmacy benefits to ensure the appropriate allocation of resources and optimal quality care in the most cost-effective manner is provided.
- Ensures that retrospective events, appeals, and grievances timeframes are in compliance with NCQA, EQRO, District of Columbia, Federal, and any other applicable standards.
- MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research.
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