Health Manager Clinical Teams, Insurance
Location: Portland Maine
Description: Martin Grant Associates is at the momment seeking for Health Manager Clinical Teams, Insurance right now, this occupation will be placed in Maine. For complete informations about this occupation opportunity kindly read the description below. $90-100K+UP TO 10% BONUS. The Manager is responsible for the day-to-day operations of the clinical integrated teams comprised of complex care management, utilization and concurrent review and population health and disease management team members. Responsibilities include compliance with all departmental, organizational, and accrediting policies, processes, and benefit guidelines. This position monitors appropriate utilization and administration of the case management programs and benefit plans to ensure consistency of decision making, quality of service and cost containment. Additionally, the manager has the responsibility of oversight for department operations and decision making in the absence of the Director. The Manager works closely with all members of the Medical Management Department as well as other Health Plan Operations and Support staff, including Claims, Member Services, Provider Inquiry, Informatics, Marketing, Product Development & Implementation and Managed Care Applications. The Manager will ensure that processes and staff comply with applicable regulatory and accrediting body standards (i.e. American Nurses Association (ANA), Case Management Society of America (CMSA) URAC, NCQA). Must be a licensed RN. Licensed as an RN in Maine and other appropriate jurisdictions as necessary BS Degree in Nursing required, Master's in nursing or related field of study preferred 5-7 years of medical management experience in a managed care setting including Case Management, Disease Management and Utilization Management. 3 + years management experience with progressive leadership roles CCM required or attained within 24 months from date of hire
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If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to Martin Grant Associates.
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This occupation starts available on: Sun, 22 Jul 2012 23:10:03 GMT