Hybrid Manager II – Medical Management

Posted last week

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About the role

  • Manager of Medical Management team at Elevance Health optimizing member benefits and promoting quality outcomes. Requires RN license, management experience, and clinical expertise.

Responsibilities

  • Manage a team of clinicians charged with promoting quality member outcomes
  • Optimize member benefits
  • Promote effective use of resources
  • Ensure adherence to medical policy and member benefits
  • Authorize inpatient admissions, outpatient services, focused surgical and diagnostic procedures, and appropriateness of treatment setting
  • Apply clinical knowledge to work with facilities and providers for care-coordination
  • Manage appeals for services denied
  • Serve as mentor to lower leveled managers
  • Develop and manage annual operating budget
  • Hire, train, coach, counsel, and evaluate performance of direct reports

Requirements

  • Requires a HS diploma or equivalent
  • Minimum of 5 years acute care clinical experience
  • Minimum of 2 years prior management experience
  • Current, active, valid unrestricted RN license to practice as a health professional within the scope of licensure in applicable state(s) or territory of the United States required
  • BS preferred
  • Demonstrated clinical expertise and leadership experience

Benefits

  • Health insurance
  • 401(k) + match
  • Paid Time Off
  • incentive bonus programs
  • Short and long term disability benefits
  • Paid holidays
  • Stock purchase plan
  • Wellness programs
  • Financial education resources

Job title

Manager II – Medical Management

Job type

Experience level

Mid levelSenior

Salary

Not specified

Degree requirement

High School Diploma

Location requirements

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