Health Underwriting Manager jobs in Muskegon, MI
Health Underwriting Manager manages the health insurance underwriting program for individuals and/or groups for medical and/or dental insurance. Ensures integrity of underwriting activities and processes. Being a Health Underwriting Manager participates in the development of master policies and other official documents. Verifies that the account contracts are in compliance with government regulations. Additionally, Health Underwriting Manager typically is a RN with clinical experience. Requires a bachelor's degree. Typically reports to a director. The Health Underwriting Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Health Underwriting Manager typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)
Recently Added Health Underwriting Manager jobs
Clinical Manager- Home Health
- The Care Team Home Health & Hospice
-
Traverse, MI
FULL_TIME
-
The Care Team The care you deserve and the support you need.
Come join our growing team! The Care Team Home Health is looking for a Full-Time Clinical Manager in Traverse City, MI, and surrounding areas. We specialize in providing Home Care in the home and facilities. If you are looking for a new and exciting opportunity, we encourage you to apply today. A member of the recruiting team will be in contact with you to discuss this opportunity in more detail. At the Care Team we offer:- Engaging Company Culture
- Competitive Compensation and Excellent Benefits
- Growth from within through training, supportive leadership, and collaboration with the best of the best in your field
- Independence, Autonomy, and Flexibility!
- Innovation and industry-leading systems and technology
As a member of The Care Team, you will enjoy a wealth of great benefit choices including:- A full benefits package including Health, dental, and vision
- 401k with company match
- Generous Paid Time Off
- Paid Holidays
- Flexible spending
- Company Paid and optional Life and Long-Term Disability, Short Term Disability
- Accident Coverage
KEY JOB RESPONSIBILITIES: The Clinical Manager ensures that the overall coordination of home health and/or hospice services provided to the patient is delivered according to acceptable standards of practice and all company procedures. This position reviews and approves patient information submitted by the licensed professional (LP). This position assists with patient care review meetings (Case Conference and Interdisciplinary Team (IDT)), the review and approval of orders, and provides oversight of patient care. The Clinical manager is responsible for assisting the branch director with day-to-day office and staff management related to patient care. This position assists the branch leadership with ongoing education and training of all branch clinicians to ensure understanding of documentation requirements to meet regulatory standards. The Clinical Manager facilitates the relationship between physicians, referral sources, patients, caregivers, and employees.Additionally, the Clinical Manager will:- Review on-call coordination notes reports daily.
- Communicate with patients and their families to introduce TCT, discuss services to be rendered, and inform them of the potential start of care visit date: follow back up with the sales team member, as needed.
- Provide educational material for family and staff on medical diagnoses, provision of care, and psychosocial aspects of chronic illness and disability, and end of life care.
- Assist with maintaining provider requirements; work with providers, sales, and clinical staff to resolved issues, as appropriate.
- Process workflow, coordination notes, and administrative tasks timely.
- Back up the intake coordinator to receive and enter referrals from payors, physicians, facilities, and staff; clearly identify who obtained the referral.
- Attach referral paperwork to medical record timely, as needed.
- Communicate acceptance of referrals clearly with referral sources, as needed.
- Back up the Patient Service Coordinator (PSC) to reschedule missed and declined visits, and process reassigned and rescheduled requests to ensure timely completion.
- Review patient schedules and approve schedule changes to ensure clinical skills of assigned staff meet patient requirements.
- Follow up on orders, as needed, when medical records is unable to retrieve the unsigned order.
- Remain up to date on internal information announcements and ensure TCT policies and procedures, critical pathways, standards of care, and practice guidelines are met.
- Provide orientation and in-service training to field and office staff to meet patient needs, particularly with documentation standards, track and document education appropriately.
- Assist the Branch Director and administrator during any survey, as directed.
- Attend and participate in staff meetings and in-services.
- Attend and participate in community education functions.
- Address action items and rocks to ensure that TCT is able to accomplish their important goals.
- Participate in administrative on-call; support the on-call nurse and provide software management related to processing intake and crucial workflow during off hours.
- Conduct continuous quality assessment and performance improvement activities, as assigned.
- Complete onsite supervisory visits, as assigned.
- Assist with the day-to-day supervisor of branch clinical operations.
- May assume a position of leadership when the branch director is out of the office; perform supervisory tasks, such as evaluations and counseling, or make hiring and termination recommendations for branch and field staff, as requested.
- Responsible for the referral intake and management process to ensure patients receive assessment visits, scheduled and performed timely by TCT policy.
- Assist branch director with patient review meetings (case conference and IDT); address care decisions based on review.
- Review and approve patient care assessment coordination notes submitted by case managers and attach to episode detail report. Contact physicians to obtain orders for continued service provision or add on services, as needed.
- Review and approve all patient information submitted by the licensed professional (LP).
- Review orders as written by clinicians; approve or decline as appropriate. Follow up with licensed professional (LP), as necessary, when editing and order.
- Ensure all orders are complete, including frequency, and that any corrections are made by the licensed professional who wrote the order, prior to approving the order; complete any follow up tasks as deemed necessary, by order.
- Enter and approve all orders; route to medical records to be sent for physician signature.
- Ensure that there are existing orders for requested medical supplies.
- Enter detailed non-admit information into patient record in coordination notes if no visit was made; ensure the branch director is informed approve the non-admission.
- Review and process all wound score deviations, documenting any action and follow up.
- Review and process vital sign alert reports; document follow-up action and physician notification.
- Receive lab reports and assess for normality; fax lab report to the physician with signature indicating review. Scan both the reviewed labs and the fax confirmation page (showing it was sent to physician) to medical records for uploading into the patient chart.
- Initiate employee and patient infection reports, as necessary.
- Complete review of evaluation documentation and plans of care (POC). Review the data submitted to ensure accuracy with the POC; follow up on any documentation that requires correction.
- Process POC and verify the correct start of care date.
- Review comprehensive assessments that cannot be processed due to licensed professional documentation deficiencies; follow up appropriately.
- Perform and maintain ongoing chart audits according to standard operating procedure.
- Assist with hospice item set data, as requested; review every error message and to seek guidance from the branch director prior to locking.
- May perform all duties and visit expectations of a licensed professional, as needed.
- May participate in on-call rotation, as needed.
- Any additional duties assigned by supervisor.
Qualifications- Previous experience performing or reviewing OASIS, or similar role, is highly preferred.
- Previous experience in Home Care Home Base (HCHB) is preferred. Advance computer skills are preferred.
- Must be organized, detail oriented, and able to manage multiple projects simultaneously.
- Must be able to work independently with minimal supervision and possess the ability to communicate effectively, both in orally and in writing.
- Must be a self-starter with the ability to work effectively independently and as a team.
- Must possess a high standard of professional ethics.
- Must possess a passion for helping patients.
- Must have strong ability to maintain a professional and friendly demeanor in a high stress environment with a broad range of individuals and demonstrate a service-oriented attitude.
- Must understand the issues related to the delivery of home health care and be able to problem-solve effectively.
- Must comply with accepted professional standards and practices.
- Maintains the agencys mission, philosophy, and core values.
- Ensures compliance with agency policies and procedures regarding operations/processes, including but not limited to those regarding patient care, patient complaints, incidents, safety and emergency management.
- Ensures compliance with policies and procedures regarding infection prevention, control, standard precautions, and infection identification reporting.
- Always maintains patient confidentiality, including all HIPAA regulations.
- Attends QAPI and management meetings, as appropriate.
Education:- Graduate of an accredited School of Nursing.
- Bachelors Degree in Nursing preferred.
- Two years as a Registered Nurse with at least one-year management experience in a home care, hospice or equivalent environment required.
Regulatory requirements:- Must be licensed as a registered nurse (RN) in the state where they currently practice, or in accordance with the board of nursing rules for nurse licensure compact for the state where they currently practice.
- Must pass a criminal background check & MVR check.
- Completed health statement acknowledging ability to perform the duties of the position.
- Valid state drivers license.
- Must maintain automobile liability insurance as required by law.
- TB testing per agency policy; (1 or 2 step TB skin test within 12 months of hire & annual TB symptom screening thereafter).
- 9 Days Ago
Registered Nurse (Mental Health Care Manager - RANGE)
- US Veterans Health Administration
-
Cadillac, MI
FULL_TIME
- Duties This nurse provides coverage for the absence of Registered Nurse, Mental Health Care Manager within the Mental Health Services practicing in designated Community Based Outpatient Clinic setting...
- 10 Days Ago
Enviornmental Health and Safety Manager
- Webb Chemical Service Corporation
-
Muskegon, MI
FULL_TIME
- The Environmental, Health, and Safety (EH&S) Manager shall be responsible to ensure compliance with all environmental, health, safety and other regulatory compliance requirements on a day-to-day basis...
- Just Posted
Environmental Health & Safety Manager
- LA COLOMBE HOLDINGS GROUP
-
Norton, MI
OTHER
- Job Details Job Location: Norton Shores Production Facility - Norton Shores, MI Position Type: Full Time Salary Range: Undisclosed Job Category: Salary Job DescriptionLa Colombe is a leading coffee ro...
- 26 Days Ago
Case Specialist Underwriting Tele-Services (Onsite)
- Western & Southern Financial Group
-
FREMONT, MI
FULL_TIME
- Overview Processes and reviews underwriting requirements by conducting customer interviews to gather non-medical and medical information. Works with some supervision but is empowered to approve applic...
- 17 Days Ago
Clinical Manager for Home Health Agency
- AdvisaCare
-
Traverse, MI
FULL_TIME
- Clinical Manager for a growing Home Health AgencyGetting ready for spring? Want more money for those vacations coming up? Come join AdvisaCare for some extra cash! Urgently Hiring!Are you a self-start...
- 2 Days Ago
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0 Health Underwriting Manager jobs found in Muskegon, MI area
Insurance Sales Agent
- Bankers Life
-
Holland, MI
- Bankers Life® seeks professionals for a dynamic hybrid remote work environment. Start your insurance agent career and ea...
- 4/23/2024 12:00:00 AM
Entry Level Insurance Sales Agent
- Bankers Life
-
Rockford, MI
- Bankers Life® seeks professionals for a dynamic hybrid remote work environment. Start your insurance agent career and ea...
- 4/23/2024 12:00:00 AM
Personal Lines Customer Service Representative
- Snelling Staffing Services
-
Grand Rapids, MI
- The Personal Lines Customer Service Representative handles various routine and specialized customer service duties and c...
- 4/22/2024 12:00:00 AM
COMPLIANCE MANAGER
- Muskegon County, MI
-
Muskegon, MI
- Salary: $37.53 - $47.72 Hourly Location : Muskegon, MI Job Type: Full-Time Job Number: 2024-01878 Department: HealthWest...
- 4/22/2024 12:00:00 AM
Compliance Specialist - Sparta
- AdvisaCare
-
Sparta, MI
- Rebound Home and Community Therapy, an AdvisaCare Healthcare Solutions, Inc company, has a successful 20 year history of...
- 4/22/2024 12:00:00 AM
Field Property Claim Representative, Grand Rapids Area
- Hastings Mutual Insurance Company
-
Grand Rapids, MI
- Hastings Mutual is currently looking for a Field Property Claim Representative! This is a great opportunity to join our ...
- 4/21/2024 12:00:00 AM
COMPLIANCE MANAGER
- Muskegon County
-
Muskegon, MI
- Description of Work An employee in this class, under the general direction of the Director of Health Information Service...
- 4/21/2024 12:00:00 AM
Compliance Specialist
- Grand River Aseptic Manufacturing
-
Grand Rapids, MI
- Quality, Service, Collaboration, Courage. Do you exhibit these values and wish to be around others that do too? Are you ...
- 4/21/2024 12:00:00 AM
About Muskegon, Michigan
Muskegon (/mʌˈskiːɡən/) is a city in the U.S. state of Michigan, and is the largest populated city on the eastern shores of Lake Michigan. At the 2010 census the city population was 38,401. The city is the county seat of Muskegon County. It is at the southwest corner of Muskegon Township, but is administratively autonomous.
The Muskegon Metro area had a population of 172,188 in 2010. It is also part of the larger Grand Rapids-Wyoming-Muskegon-Combined Statistical Area with a population of 1,321,557....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Health Underwriting Manager jobs
$114,749 to $148,884
Muskegon, Michigan area prices
were up 1.3% from a year ago
were up 1.3% from a year ago
What does a Health Underwriting Manager do?
Health Underwriting Manager in Springfield, OH
A health insurer or Health Plan accepts responsibility for paying for the health care services of covered individuals in exchange for dollars, which are referred to as premiums.
February 23, 2020
Health Underwriting Manager in Bellingham, WA
Underwriting helps decide whether to accept an applicant.
January 16, 2020
Health Underwriting Manager in Danbury, CT
Excellent underwriting capabilities can make possible not only sustained risk taking but also greater efficiency, organizational growth, a better customer experience—and even improved patient health.
December 08, 2019