Manager I in Medicaid Medical Management overseeing non-clinical specialists ensuring compliance and service delivery. Responsible for training and managing a team to improve program efficiency.
Responsibilities
Responsible for supporting the Medicaid Medical Management team by managing and overseeing non-clinical medical management specialists to ensure utilization regulatory compliance and member service delivery
Oversees compliance with turnaround times, productivity metrics, reporting, and call times
Supervises approximately 20 non-clinical medical management specialists
Manages resource utilization to ensure appropriate delivery of care to members
Adequate coverage for all tasks and job responsibilities
Participates in cross-functional workgroups created to maintain and develop program
Evaluates current processes of Special Program's support functions; recommends changes for increased efficiencies and improved outcomes
Develops and conducts training programs for staff involved in the program
Extracts and manipulates analytical data to present findings to relevant markets and stakeholders
Hires, trains, coaches, counsels, and evaluates performance of direct reports
Requirements
Requires a BA/BS
minimum of 5 years experience in a related field
minimum of 1 year leadership/management experience
Utilization review/utilization management experience is a must
A current unrestricted RN license issued by the Commonwealth of Virginia is very strongly preferred
Senior Manager managing creator relationships and strategies at OverCast Digital, a leading TikTok Shop Partner. Driving GMV through effective creator program management in a hybrid role.
Transportation Manager developing domestic logistics strategy for Sally Beauty. Leading transportation operations and improving service performance with a focus on cost - effectiveness.
District Manager responsible for driving sales success across diverse territories. Focusing on customer relationships and strategic initiatives while working closely with multiple stakeholders.
Care Manager 1 providing statewide care management for Medicaid enrolled members in NC. Working remotely while coordinating integrated care services and developing care plans.
Residential Manager overseeing Adult Residential Service Program in Tacoma. Responsible for supervising programs and helping clients achieve independence and quality care.
Excursions Manager responsible for managing daily tour operations and supervising staff in Hoonah, AK. Focus on guest satisfaction and operational consistency with oversight of excursions.
Responsable de programmes gérant des opérations de transformation des patrimoines pour Nhood à Lille. Pilotage des projets immobiliers mixtes avec une forte coordination entre équipes.
Associate Impact Manager at BlueOrchard contributing to ESG and impact management activities. Engaging in assessments, reporting, and enhancing impact management practices.
RN Case Manager coordinating nursing care for patients in Western North Carolina. Instructing and supervising staff while managing caseloads and assessing patients' health.
IT Manager providing leadership for the technical team managing Oracle Retail Point of Service. Engaging with business partners and driving strategic vision while managing support operations.