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)
Job Summary
**Hybrid Work Environment - Must reside on Oahu **
Pay Range: $73,154 - $121,252, position is eligible for an incentive bonus
Note: Individuals typically begin between the minimum to middle of the pay range
The Manager, Internal Ops Liaison, Claims is responsible for providing leadership direction and oversight of the daily claim operations. This results-oriented manager will be accountable for all facets of strategic initiatives, including implementation of policies, performance guarantees and programs in support of timely and accurate claims processing. Additionally, this Manager will represent Claims Operations in critical and/or complex inter departmental strategic goals and initiatives that directly impact operations.
Exempt or Non-Exempt
Exempt
Minimum Qualifications
Duties and Responsibilities
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