Manager I Medical Mgmt
Core
Manage a team of clinicians to promote quality member outcomes, optimize member benefits, and ensure effective use of resources in federal healthcare programs.
Role type
Manager I Medical Mgmt
Builds
Member health outcomes and optimized benefit utilization for federal populations
Domain
Healthcare / Federal Government
Deliverable
client delivery
Required skills
Acute care clinical experience, RN licensure, medical policy interpretation, care coordination, team management, appeals management
Preferred skills
Analytical skills, problem-solving, facilitation
Technologies
Managed care products, community resources
Responsibilities
Ensure adherence to medical policy and member benefits; authorize outpatient and home health services; coordinate care with facilities and providers; manage appeals for denied services; hire, train, coach, and evaluate direct reports
Seniority
Manager, hands-on team lead