Manager II – Medical Management

Role Overview

• 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