Medical Claims Review Manager jobs in Anchorage, AK
Medical Claims Review Manager oversees the performance, productivity, and quality of the medical claims review staff. Responsible for hiring, training, and firing medical claims review staff. Being a Medical Claims Review Manager evaluates medical claims review processes and recommends process improvements. Serves as a technical resource for all medical review workers. Additionally, Medical Claims Review Manager typically requires an RN or BSN. Requires a bachelor's degree. Typically reports to a head of a unit/department. The Medical Claims Review 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. Extensive knowledge of department processes. To be a Medical Claims Review Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)
Recently Added Medical Claims Review Manager jobs
UTILIZATION REVIEW MANAGER
- North Star Behavioral Health
-
Anchorage, AK
FULL_TIME
-
Responsibilities:UTILIZATION REVIEW MANAGER OPPORTUNITY
North Star Behavioral Health, Alaska's premier mental health facility, is on a mission to provide hope and healing to individuals facing psychiatric or substance abuse challenges. We specialize in military-specific care for first responders, service members, veterans, and their dependents through the Chris Kyle Patriots Hospital. Our commitment is to prioritize patient care, offering excellence, comfort, and security during their most vulnerable moments. Join us, and you'll become part of a supportive network of peers and leaders dedicated to continuous learning and industry excellence. At North Star, your career can thrive through robust education opportunities and advancement within the Universal Health Services (UHS) network.
Visit us at: www.northstarbehavioral.com
Who is North Star: At North Star Behavioral Health, we are dedicated to delivering a level of care that not only meets but exceeds expectations. Our vision is simple yet profound: to provide care that patients enthusiastically recommend to their family and friends, care that physicians prefer for their patients, and care that our employees take pride in delivering every day.We uphold this vision by wholeheartedly embracing the following principles:- Service Excellence
- Continuous Improvement
- Employee Development
- Ethical and Fair Treatment
- Teamwork
- Compassion
- Innovation
Our commitment to excellence isn't just a slogan—it's a way of life at North Star Behavioral Health. If you share these values and are passionate about making a positive impact on the lives of individuals and families facing mental health challenges, we invite you to join our team.
Benefits include:- Challenging & Rewarding Work Environment
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision, and Prescription Drug Plans
- 401(K) with Company Match & Discounted Stock Plan
- SoFi Student Loan Refinancing Program
- Career Development Opportunities within UHS and its 300 Subsidiaries!
- Tuition Assistance
Together, we can continue to provide the highest level of care and create a brighter future for those we serve.
As the Controller at North Star, you will report to the CFO and play a crucial role in overseeing the accounting operations. You will be responsible for producing financial reports, maintaining robust accounting records, and implementing controls and budgets to mitigate risk and ensure compliance with accounting standards.
SHIFT: 8 hour shifts
SCHEDULE: Monday - Friday, 9:00 AM - 5:00 PM
Key Responsibilities:
Leadership Collaboration: Actively participates in leadership discussions and decision-making processes as a valued member of the Leadership Team.- Utilization Management Oversight: Manages all utilization management activities, including PHP/IOP/off-campus programs, ensuring compliance with regulatory requirements.
- Documentation Training: Provides documentation training for clinical staff, including physicians, nursing, social services, and discharge planner, during New Employee Orientation.
- Physician Engagement and Liaison: Engages with physicians daily to ensure compliance, serves as a key liaison with hospital physicians, aligning engagement with payer expectations, patient acuity, and discharge planning requirements.
- UM Plan Development and Resource Management: Develops and updates the Utilization Management (UM) Plan, manages and tracks Physician Certification Forms and Emergency Care Attestations, and oversees resource management, addressing trends within the facility.
- Quality Assurance and Education: Acts as the Medical Necessity Expert, providing guidance to physicians and leadership, offering ongoing education to facility providers on Medical Necessity Guidelines, Level of Care, and payer changes.
Qualifications:Qualifications:- Bachelor's degree in Social Work or related field.
- Three (3) years clinical experience with a psychiatric mental health population preferred.
- Proven experience in a similar leadership role.
- Must be 21 years of age
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $12.6 billion in 2021. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 89,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
EEO StatementAll UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
NoticeAt UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449. - 18 Days Ago
Account Manager
- ROY BRILEY ASSOCIATION MANAGER
-
Anchorage, AK
PART_TIME,CONTRACTOR,TEMPORARY,FULL_TIME
- Job description Provides lead group direction and day-to-day financial oversight of budget, accounting, project accounting. Provides strategic leadership and analysis in the utilization of information...
- 7 Days Ago
Medical Claims Specialist I, II, III - (Salary: DOE)
- Alaska Native Tribal Health Consortium
-
Anchorage, AK
FULL_TIME
- The Alaska Native Tribal Health Consortium is a non-profit Tribal health organization designed to meet the unique health needs of Alaska Native and American Indian people living in Alaska. In partners...
- 12 Days Ago
Medical Claims Specialist II - Purchased Referred Care - Closes: 10/04/2022
- Alaska Native Tribal Health Consortium
-
Anchorage, AK
FULL_TIME
- The Alaska Native Tribal Health Consortium is a non-profit Tribal health organization designed to meet the unique health needs of Alaska Native and American Indian people living in Alaska. In partners...
- 6 Days Ago
Medical Claims Specialist II - Purchased Referred Care - Closes: 8/16/2023
- Alaska Native Tribal Health Consortium
-
Anchorage, AK
FULL_TIME
- The Alaska Native Tribal Health Consortium is a non-profit Tribal health organization designed to meet the unique health needs of Alaska Native and American Indian people living in Alaska. In partners...
- 22 Days Ago
Document Review Attorney - Alaska
- Morgan & Morgan, P.A.
-
Anchorage, AK
FULL_TIME
- Summary Morgan & Morgan is looking for an attorney that is barred and resides anywhere in Alaska to assist with E-Discovery / Document Review on mass tort and class action cases. The E-Discovery Attor...
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0 Medical Claims Review Manager jobs found in Anchorage, AK area
Remote Licensed Marriage and Family Therapist
- Headway
-
Wasilla, AK
- Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
- 4/15/2024 12:00:00 AM
Remote Licensed Psychiatric Nurse Practitioner
- Headway
-
Wasilla, AK
- Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
- 4/15/2024 12:00:00 AM
Remote Licensed Clinical Social Worker
- Headway
-
Wasilla, AK
- Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
- 4/15/2024 12:00:00 AM
Remote Licensed Mental Health Counselor
- Headway
-
Wasilla, AK
- Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
- 4/15/2024 12:00:00 AM
Remote Licensed Professional Counselor
- Headway
-
Wasilla, AK
- Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
- 4/15/2024 12:00:00 AM
Remote Licensed Psychiatric Nurse Practitioner
- Headway
-
Anchorage, AK
- Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
- 4/14/2024 12:00:00 AM
Remote Licensed Clinical Social Worker
- Headway
-
Anchorage, AK
- Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
- 4/14/2024 12:00:00 AM
Physician Assistant/ Nurse Practitioner- Outpatient Clinic
- Doyon
-
Anchorage, AK
- Overview JOB SUMMARY: * To provide acute and occupational medical care * Outpatient Clinic Setting * Monday - Friday 8AM...
- 4/13/2024 12:00:00 AM
About Anchorage, Alaska
Anchorage (officially called the Municipality of Anchorage; Dena'ina: Dgheyaytnu) is a unified home rule municipality in the U.S. state of Alaska. With an estimated 298,192 residents in 2016, it is Alaska's most populous city and contains more than 40 percent of the state's total population; among the 50 states, only New York has a higher percentage of residents who live in its most populous city. All together, the Anchorage metropolitan area, which combines Anchorage with the neighboring Matanuska-Susitna Borough, had a population of 401,635 in 2016, which accounts for more than half of the s...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$107,524 to $137,095
Anchorage, Alaska area prices
were up 2.8% from a year ago
were up 2.8% from a year ago
What does a Medical Claims Review Manager do?
Medical Claims Review Manager in Paramus, NJ
Support management with leading Medical Review team to ensure all types of claims requiring medical reviews are completed in compliance with State, Federal, accreditation standards and other applicable regulations.
February 01, 2020
Medical Claims Review Manager in Nashua, NH
By truly combining claims and bill review, the two systems are kept in sync utilizing the scheduled jobs of the aforementioned standard model; however, for real-time data updates, claims examiners are granted access to the entire live bill review system.
January 13, 2020
Medical Claims Review Manager in Davenport, IA
Complex claim errors can only be caught by physician reviewers with the clinical experience to spot mistakes that automated systems can’t detect.
January 03, 2020