Job Listings

The Value-Based Purchasing & Care Director is accountable for the transformation and performance of value-based programs with large provider systems contracting with the health plan. This leader has direct accountability for the design and development of value-based program strategies with provider system leadership - including the execution, oversight, and sustainment of high performance in the areas of healthcare quality, organizational cost, and patient experience.   This role is pivotal in positioning and differentiating the health plan to lead the market in the adoption and advancement of value-based care and alignment of payer and provider...

The Medical Director reports to Presbyterian Health Plan's (PHP) Senior Medical Director. S/he will be primarily responsible for daily performing medical necessity determinations in partnership with PHPs Utilization Management and is responsible for ensuring that medical protocols and practice guidelines.   This includes utilization management of health care services primarily with the prior authorization staff, participation in formulating complex care coordination, as well as peer-to-peer discussions with community clinicians.   The Medical Director will also provide medical oversight, expertise,...

As a member or the hospital executive leadership team, reporting to the VP of Finance Operations, the Finance Director oversees the financial operations of the hospital entity. This role provides strategic leadership in financial planning/forecasting, capital planning, budgeting, financial reporting, as well as ensure compliance with all regulatory requirements within a highly matrixed organization.   Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with...

The Director of the Procurement Center of Excellence (CoE) will serve as a strategic leader within the enterprise procurement function, responsible for designing, leading, and continuously improving the tools, processes, policies, and capabilities that enable best-in-class procurement performance across Presbyterian Healthcare Services (PHS). This individual will oversee procurement transformation initiatives, drive enterprise-wide standardization and adoption, and enable high-impact decision-making through analytics and insights. This role will directly support the entire Enterprise including the health plan and care delivery system procurement teams, fostering a...

The Director of Strategic Sourcing for the Health Plan will lead sourcing strategy, supplier management, contracting, and cost optimization initiatives for all categories of spend supporting Presbyterian Health Plan. This includes categories such as third-party administrative services, pharmacy benefit management (PBM), behavioral health, IT and digital, care coordination, population health programs, marketing, consulting, and other non-clinical categories. This individual will work closely with internal business owners, finance, legal, compliance, and vendor partners to ensure value-driven, performance-oriented sourcing decisions that align with the strategic and...

The Director of Nursing plans, directs and coordinates the operational, financial and personnel activities of designated departments. This position specifically oversees direct reports in the critical care department inlcuding the emergency department and ICU.  Presbyterian Rust Medical Center is conveniently located for patients and members living on Albuquerque's west side, offering patient-centered, environmentally friendly, and technologically innovative care. Our facility features: a family birthing unit offering midwifery and obstetrics services, a multidisciplinary cancer program, breast care, physician office building, an ER, and an ICU. 

The Director of Practice Administration is responsible and accountable for all administrative aspects, customer service and financial performance of the clinic. You will lead strategic, tactical and CQI planning, overseeing implementation and ongoing measure of same. This leader directs clerical oversight and collaborates with Administrative Director of the clinics to ensure sites provide high quality, cost-effective care. You will also serve as a support and liaison to providers.   Nestled between tall pines and mountain vistas at an elevation of

The Director of Clinical Programs leader is responsible for identifying, implementing, and overseeing new in-house and vendor-delivered clinical programs to achieve organizational population health and quality goals across the risk continuum and for all lines of business, with a focus on Medicare Stars, Medicaid performance measures, and other clinical quality outcomes for highly impactable priority populations across all health plan products. This leader is responsible for clinical and operational direction and oversight of daily operations for Presbyterian Health Plans existing disease management program and nurse advice line.   This...

The Director of Claims and Encounters provides strategic leadership, fiscal accountability and operational excellence for the Presbyterian Health Plan (PHP) Claims Operations and Encounter Resolution teams. This leader is responsible for directing the operations of the Claims Department for Commercial/ASO, Medicare and Medicaid products, to ensure that all functions related to claims receipt, processing and payment are performed within the established quality and quantity standards. You will lead the encounters resolution team and be the leader responsible for encounters completeness and facilitating maximized Medicaid rate setting. This leadership role is accountable to drive execution of...

The Director of Nursing for Primary and Urgent Care directs and is accountable for nursing practice, education and nursing services for Primary/Urgent Care. The director provides leadership for nursing and works with clinical teams to provide high-quality, cost-effective patient care. This person will also ensure full integration of nursing practice. This leader functions as a primary/urgent care nursing liaison across the continuum of care within the PHS Network and serves as the resource for the Primary /Urgent Care dyad for nursing and clinical processes.

The Director of IT Applications is responsible for oversight and management of all Presbyterian Healthcare Services software systems including but not limited to Enterprise, Financial, Clinical, Ambulatory, Administrative and Revenue Cycle Systems. This leader provides strategic direction, budget management, development, implementation and maintenance of these systems through Life Cycle Management methodology in a service-oriented manner.    Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From...