Independent Peer Review Manager at Babcock overseeing safety standards and compliance in high - hazard engineering environments. Leading a team to manage safety cases and design modifications for national security.
About the role
- Manager I in Medicaid Medical Management overseeing non-clinical specialists ensuring compliance and service delivery. Responsible for training and managing a team to improve program efficiency.
Responsibilities
- Responsible for supporting the Medicaid Medical Management team by managing and overseeing non-clinical medical management specialists to ensure utilization regulatory compliance and member service delivery
- Oversees compliance with turnaround times, productivity metrics, reporting, and call times
- Supervises approximately 20 non-clinical medical management specialists
- Manages resource utilization to ensure appropriate delivery of care to members
- Adequate coverage for all tasks and job responsibilities
- Participates in cross-functional workgroups created to maintain and develop program
- Evaluates current processes of Special Program's support functions; recommends changes for increased efficiencies and improved outcomes
- Develops and conducts training programs for staff involved in the program
- Extracts and manipulates analytical data to present findings to relevant markets and stakeholders
- Hires, trains, coaches, counsels, and evaluates performance of direct reports
Requirements
- Requires a BA/BS
- minimum of 5 years experience in a related field
- minimum of 1 year leadership/management experience
- Utilization review/utilization management experience is a must
- A current unrestricted RN license issued by the Commonwealth of Virginia is very strongly preferred
- Experience monitoring associate productivity (i.e. metrics)
- Prior experience in Medicaid, FIDE, and LTSS markets is very helpful
- Must be computer literate and comfortable using a variety of applications, especially Word and Excel
- Strong critical thinking and organizational skills are essential
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical benefits
- dental benefits
- vision benefits
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
Manager coordinating global technical evaluations of new in - licensed products for Sandoz. Ensuring evaluations meet business needs and aiding product launches within technical frameworks.
Senior Loyalty Business Programs Manager responsible for business processes and strategies at Expedia Group. Collaborating with cross - functional teams to enhance travel experiences and profitability.
Senior Consulting Manager for Japanese Business Services focusing on practice development and client engagement. Supporting Japanese - owned companies through consultancy and relationship building between Japan and the US.
Land Acquisition Discipline Manager managing land acquisition staff and interfacing with project managers at Hanson. Ensuring compliance and quality delivery of land acquisition services in various markets.
Manager leading cross - divisional housing initiatives with Indigenous and private partners in Toronto. Overseeing housing program development and stakeholder engagement for the City’s Housing Secretariat.
Senior Manager driving post - merger integration of Atos Medical while collaborating with executives. Engaging in strategic projects and contributing to business development in an international context.
Engagement Manager at LexisNexis guiding legal customers through integrating AI products. Building relationships and assessing needs for effective transitions of solutions.
Area Manager overseeing distribution operations ensuring efficiency and quality at QVC Group’s fulfillment center. Leading teams and implementing processes in a dynamic retail environment.
Brand Manager leading Home Private Brands for QVC Group, enhancing product development and managing brand standards. Collaborating across design, sourcing, and sales teams to achieve financial results.