Manager Medical Policy

Posted 17 days agoViewed

💎 Seniority level: Manager, 5 years clinical experience, 10 years managed care experience

📍 Location: United States of America

🔍 Industry: Health Insurance

🏢 Company: external

🗣️ Languages: English

⏳ Experience: 5 years clinical experience, 10 years managed care experience

🪄 Skills: LeadershipCommunication SkillsResearch skills

Bachelor's Degree or equivalent work experience required.
5 years of clinical experience required.
10 years of managed care experience utilizing clinical and analytical knowledge.
Active Registered Nurse (RN) license in Tennessee or compact states.
Excellent oral and written communication skills.
Proficient in Microsoft Office (Outlook, Word, Excel, Access, PowerPoint).
Strong organizational skills and ability to handle multiple projects.
Expertise in evidence-based medicine and technology review.

Supervises the work of Medical Policy Research Consultants.
Assigns medical policy and project requests to consultants.
Trains and assesses consultants' work and provides feedback.
Establishes clinical quality indicators for the department.
Responds to high-level and complex inquiries from physicians.
Researches and presents clinically related decision-making tools.
Provides project leadership for high-level projects involving various departments and external provider groups.