Manager Medical Management

Responsible for managing a team of clinicians to promote quality member outcomes, optimize member benefits, and effectively use resources. Ensures adherence to medical policy and member benefits, and manages areas such as authorizing inpatient admissions and out of network services.

Requirements

• Current active unrestricted RN license to practice as a health professional within the scope of practice in applicable state(s) or territory of the United States
• 5 years acute care clinical experience
• Strong oral, written and interpersonal communication skills
• Problem-solving skills, facilitation skills, and analytical skills