IT Risk Manager consulting for FTSE 100/250 and start - ups. Engaging in IT Internal Audit and SOX compliance activities with a focus on client relationships.
About the role
- Manager of Medical Management team at Elevance Health optimizing member benefits and promoting quality outcomes. Requires RN license, management experience, and clinical expertise.
Responsibilities
- 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
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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