Utilization Management & Compliance Director - (El Segundo, CA)

Responsible for developing, integrating, implementing and monitoring compliance with the Utilization Management Plan including policies and procedures across health plans, NCQA and other regulatory agencies. Serves as a liaison between the medical group and the governing agencies in accordance with the Office of the Medical Director/Quality Management Sessions (OMD/QS). Works as a cross-functional team player with Care Management, Quality Improvement, Risk Management, MCA and Contracting. REQUIRED FUNCTIONS: · Consistently exhibits behavior and communication abilities that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer.