Manager II Medical Management overseeing teams of clinicians at Elevance Health. Responsible for optimizing member outcomes and managing healthcare resources while ensuring adherence to policies and procedures.
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 in providing service
Manages areas which may include authorizing inpatient admissions, outpatient services, focused surgical and diagnostic procedures
Applies clinical knowledge to work with facilities and providers for care-coordination
May also manage appeals for services denied
Serves as mentor to lower leveled managers
Develops and manages annual operating budget
Hires, trains, coaches, counsels, and evaluates 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
BS preferred
MS Office Suite experience preferred
Health plan experience preferred
Management experience preferred
Production environment experience preferred
Clinical experience in an ER/trauma unit preferred
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