Hybrid Manager II – Medical Management

Posted 2 weeks ago

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About the role

  • 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

Benefits

  • comprehensive benefits package
  • incentive and recognition programs
  • equity stock purchase
  • 401k contribution
  • merit increases
  • paid holidays
  • Paid Time Off
  • short and long term disability benefits
  • life insurance
  • wellness programs
  • financial education resources

Job title

Manager II – Medical Management

Job type

Experience level

Mid levelSenior

Salary

$115,092 - $180,144 per year

Degree requirement

High School Diploma

Location requirements

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