Managed Care Marketing Manager develops and implements marketing plans for a managed care organization. Promotes the organization's services to potential members and business partners. Being a Managed Care Marketing Manager identifies and targets new opportunities and sources of additional business and revenue. Requires a bachelor's degree. Additionally, Managed Care Marketing Manager typically reports to a head of a unit/department. The Managed Care Marketing Manager typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Managed Care Marketing Manager typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)
Job Summary
The Managed Care Specialist serves as the managed care liaison by submitting clinical information and obtaining managed care authorizations for acute care patients through communication with representatives of managed care organizations. Collaborates with Unit Based Case Managers and/or Physicians to determine acute care criteria prior to contacting managed care organizations. Knowledgeable of all payor notification requirements. Works with Patient Accounting Department for resolution of payor reimbursement issues. Facilitates denial management by working with the Physician Advisor and the Denial Managers to ensure appropriate documentation of activities to maximize positive financial outcomes.
Essential Job Functions
Required Qualifications
Preferred Qualifications
License, Certification & Clearances
Supervisory Responsibilities
Position Type/Expected Hours of Work
LEAN
AAP/EEO
Work Environment
Effective March 2020 or during pandemic: goggles, face shield and mask are required according to CDC guidelines
When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.
Essential – Absolute Necessity.
Marginal – Minimal Necessity.
Constantly – 5.5 to 8 hours or more or 200 reps/shift.
Frequently – 2.5 to 5.5 hours or more or 32-200 reps/shift.
Occasionally – 0.25 to 2.5 hours or 2-32 reps/shift.
Rarely – Less than 0.25 hours or less than 2 reps/shift.
Physical Condition
Essential
Marginal
Constantly
Frequently
Occasionally
Rarely
Never
Extreme Heat
x
Extreme Cold
x
Heights
x
Confined Spaces
x
Extreme Noise(>85dB)
x
Mechanical Hazards
x
Use of Vibrating Tools
x
Operates Vehicle (company)
x
Operates Heavy Equipment
x
Use of Lifting/Transfer Devices
x
Rotates All Shifts
x
8 Hours Shifts
x
x
10-12 Hours Shifts
x
x
On-Call
x
Overtime( 8/hrs/shift; 40/hr/wk)
x
Travel Between Sites
x
x
Direct Patient Care
x
Respirator Protective Equipment
x
Eye Protection
x
Head Protection (hard hat)
x
Hearing Protection
x
Hand Protection
x
Feet, Toe Protection
x
Body Protection
x
Latex Exposure
x
x
Solvent Exposure
x
Paint (direct use) Exposure
x
Dust (sanding) Exposure
x
Ethylene Oxide Exposure
x
Cytotoxic (Chemo) Exposure
x
Blood/Body Fluid Exposure
x
Chemicals (direct use) Exposure
x
Mist Exposure
x
Wax Stripper (direct use)
x
Non-Ionizing Radiation Exposure
x
Ionizing Radiation Exposure
x
Laser Exposure
x
Physical Demands
When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.
Essential – Absolute Necessity.
Marginal – Minimal Necessity.
Constantly – 5.5 to 8 hours or more or 200 reps/shift.
Frequently – 2.5 to 5.5 hours or more or 32-200 reps/shift.
Occasionally – 0.25 to 2.5 hours or 2-32 reps/shift.
Rarely – Less than 0.25 hours or less than 2 reps/shift.
Physical Condition
Essential
Marginal
Constantly
Frequently
Occasionally
Rarely
Never
Bending (Stooping)
x
x
Sitting
x
x
Walking
x
x
Climbing Stairs
x
x
Climbing Ladders
x
Standing
x
x
Kneeling
x
Squatting (Crouching)
x
x
Twisting/Turning
x
x
Keyboard/Computer Operation
x
x
Gross Grasp
x
Fine Finger Manipulation
x
x
Hand/Arm Coordination
x
x
Pushing/Pulling(lbs. of force)
x
<10#
Carry
x
<10#
Transfer/Push/Pull Patients
x
Seeing Near w/Acuity
x
x
Feeling (Sensation)
x
x
Color Vision
x
x
Hearing Clearly
x
x
Pulling/Pushing Objects Overhead
x
Reaching Above Shoulder Level
x
x
Reaching Forward
x
x
Lifting Floor to Knuckle
x
<10#
Lifting Seat Pan to Knuckle
x
<10#
Lifting Knuckle to Shoulder
x
<10#
Lifting Shoulder to Overhead
x
<10#
When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
Clear All
0 Managed Care Marketing Manager jobs found in Johnstown, PA area