Medical Claims Review Manager jobs in Richland, WA

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)

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Project Manager
  • GT Medical Technologies Inc
  • Richland, WA FULL_TIME
  • Description

    Status Full-time 30 Hours, Salary, Exempt 

    Department Operations

    Location Richland, WA

    Reports To Sr. Project Manager

    Travel 10 - 25%

      

    GammaTile®

    The journey for a patient with a brain tumor is an emotional one. Newly diagnosed patients usually present in the emergency department following a change in vision, balance, or cognitive function. Their world is soon turned upside down in a race to surgery. Far too many patients (~50% for glioblastomas) recur within a few months and are forced, with dedicated family members and clinicians, to navigate treatment options yet again. Unfortunately, it has been over a decade since an innovative option has been cleared by FDA…until GammaTile® Therapy! GT Medical™ technologies exists for those patients, care givers, and clinicians who need a better option. Our Corporate Purpose is to Improve the Lives of Patients with Brain Tumors and that drives us every day. 

    GammaTile® Therapy is supported by 100 amazing teammates who collaborate organically, challenge appropriately, and are consumed with assisting the next patient on the table. We have a great core team, an innovative solution, and the finances to support more growth. We are now in need of a Project Manager for our manufacturing facility in Richland, WA. If you have a heart for patients with brain tumors, excellent project management skills, and and a good balance of strategy and tactical execution, we’d love to talk to you!


    Position Summary

    This role is responsible for managing all aspects of complex projects supporting integration activities as it relates to manufacturing processes, systems, and people. This individual will drive the accomplishment of project objectives through detailed planning, leveraging best practices, risk identification and mitigation, resource alignment, evaluation of priorities, precise communication, and establishment of robust governance and progress reporting. 


    Job Duties/Responsibilities

    • Develop, drive, track and report on integrated program plans, detailed project schedules, critical path analysis, project and product risks, and program deliverables.
    • Coordinate activities and resources across multiple departments and facilities, including Operations, Customer Operations, Manufacturing, Marketing, R&D, Quality, Clinical, and Regulatory Affairs.
    • Support project budget development and ensure annual project budget targets are met by overseeing project costs including capital expenditure and expenses and related reporting.
    • Support PMO department development and deployment of robust governance and processes to initiate, execute and track progress of GT Medical Technology projects. 
    • Demonstrate ability, confidence, and strong communication skills to lead project, portfolio, and status meetings with internal cross-functional teams, external partners, and senior executives.
    • Provide guidance on priorities, scheduling, and resolution of open issues, while maintaining compliance in a regulated product development environment.
    • Consult and provide advice, facilitate discussions, and resolve conflict; establish trust; build and use cross-functional relationships to accomplish work objectives.
    • Monitors and communicates the progress of the delivery and ensures timely and effective communication of the status in terms of cost, forecast, schedule and assessment of risks/issues
    • Adheres to the Company’s purpose operating principles, building a positive and productive team culture.
    • Comply with Company policies and procedures.
    • Authorized to access employee and/or patient PHI and ePHI only as needed for job-related functions.
    • Other duties as assigned. 

    Requirements

    Qualifications

    • BS Degree in Project Management or relevant degree. 
    • Minimum 3 years of years of experience as a program/project manager.
    • Minimum 3 years of relevant work experience in medical device or pharmaceutical industry.
    • Project Management Professional (PMP) preferred. 
    • Ability to establish business cases within a project in consultation with business partners.
    • Familiarity with key FDA medical device regulations (IEC 62304, ISO 14971, ISO 13485).
    • In-depth knowledge of the product development process and medical device design control requirements, including a working knowledge of GMP’s and ISO standards.
    • Ability to lead, collaborate, challenge and influence peers, subordinates, and senior management.
    • Ability to prepare for and lead technical reviews and decision meetings. Can clearly document options and trade-offs to facilitate problem solving.
    • Self-accountable for flawless project execution.
    • Demonstrate clear bias for action and a sense of urgency.
    • Demonstrated ability to successfully influence people and teams at levels without direct authority.
    • Demonstrated analytical, decision making, prioritization and problem-solving skills.
    • Ability to manage multiple priorities.
    • Follow all safety rules and safety procedures.
    • Ability to understand federal and state regulations and company policies and procedures related to radiation safety.
    • Excellent written and verbal communication skills.
    • Proficient in using Microsoft office programs (Word, Excel and PowerPoint)
    • Proficient in using MS Project and Visio.
    • Willingness to work a flexible schedule. 
    • Able to travel for work as needed.
    • Satisfactorily pass comprehensive background screening. 

    Physical Demands/Working Conditions

    • Typical work environment for a professional office and home office space and occasionally works in a laboratory, supply room, and/or clean room environment.
    • Occasional exposure to hazardous materials requiring appropriate PPE and precautions when working with hazardous materials and chemicals.
    • Largely a stationary role with some moving from place to place.
    • Constant use of a computer, keyboard, mouse, monitor and other office equipment.
    • Occasional use of laboratory equipment.
    • Requires some finite hand/eye coordination.
    • Occasionally picks up, carries, and moves items up to 30 lbs.
    • Some evening and weekend work depending upon workload.
    • Some overnight travel will be required for work, events, and training
  • 5 Days Ago

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Paid Product Tester
  • Product Review Jobs
  • Paterson, WA FULL_TIME
  • Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
  • 20 Days Ago

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Paid Product Tester
  • Product Review Jobs
  • Eltopia, WA FULL_TIME
  • Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
  • 20 Days Ago

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Care Manager MSW *Up to $5,000 Hiring Bonus
  • Kadlec Regional Medical Center
  • Richland, WA PART_TIME
  • Description _$5,000 hiring bonus for eligible external hires that meet required qualifications and conditions for payment._ Care Manager MSW - Clinical Resource Management at Kadlec Regional Medical C...
  • 29 Days Ago

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Radiological Control Program Review Consultant [PR0117I]
  • ProSidian Consulting, LLC
  • Richland, WA FULL_TIME
  • Company DescriptionProSidian is a Management and Operations Consulting Services Firm focusing on providing value to clients through tailored solutions based on industry-leading practices. ProSidian se...
  • 25 Days Ago

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Safety Basis Review Subject Matter Expert (SME)
  • ProSidian Consulting, LLC
  • Richland, WA FULL_TIME
  • Company DescriptionProSidian is a Management and Operations Consulting Services Firm focusing on providing value to clients through tailored solutions based on industry-leading practices. ProSidian se...
  • 1 Month Ago

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0 Medical Claims Review Manager jobs found in Richland, WA area

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Physician / Psychiatry / Washington / Permanent / Psychiatry Physician Job Near Richland, WA Job
  • Md Staff Llc
  • Richland, WA
  • A counseling center near Richland, WA is seeking a psychiatrist to join an outpatient practice with weekend in-house cal...
  • 4/16/2024 12:00:00 AM

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Physician / Pulmonology / Washington / Permanent / Psychiatry Physician Job Near Richland, WA Job
  • Md Staff Llc
  • Richland, WA
  • A licensed psychiatric hospital near Richland is now accepting BC/BE CHILD/ADOLESCENT PSYCHIATRY candidates to join thei...
  • 4/16/2024 12:00:00 AM

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Remote Licensed Marriage and Family Therapist
  • Headway
  • Kennewick, WA
  • 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

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Remote Licensed Professional Counselor
  • Headway
  • Kennewick, WA
  • 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

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Remote Licensed Mental Health Counselor
  • Headway
  • Kennewick, WA
  • 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

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Remote Licensed Clinical Social Worker
  • Headway
  • Kennewick, WA
  • 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

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Remote Licensed Psychiatrist
  • Headway
  • Kennewick, WA
  • 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

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Remote Licensed Psychiatric Nurse Practitioner
  • Headway
  • Kennewick, WA
  • 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

Richland (/ˈrɪtʃlənd/) is a city in Benton County in the southeastern part of the State of Washington, at the confluence of the Yakima and the Columbia Rivers. As of the 2010 census, the city's population was 48,058. July 1, 2017, estimates from the Census Bureau put the city's population at 56,243. Along with the nearby cities of Pasco and Kennewick, Richland is one of the Tri-Cities, and is home to the Hanford nuclear site. Richland is located at 46°16′47″N 119°16′53″W / 46.27972°N 119.28139°W / 46.27972; -119.28139 (46.279657, -119.281377). According to the United States Census Bureau, t...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$102,841 to $131,123
Richland, Washington area prices
were up 2.9% from a year ago

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