Medical Management Manager manages the organization's medical management programs, which may include case management, utilization review, quality management, or community health education programs with the goal of providing high quality, cost effective health care services. Collects and analyzes data on utilization, outcomes, safety, and costs to determine trends and identify problem areas. Being a Medical Management Manager presents findings, proposed solutions, and implementation plans to management. Implements long and short term solutions for improvements in patient care and cost savings. Additionally, Medical Management Manager requires a bachelor's degree. Typically reports to a head of a unit/department. The Medical Management 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 Management 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)
POSITION PURPOSE:
Responsible for the day-to-day delivery of individual support program services to assigned case load in accordance with Federal, State, and facility codes, regulations, guidelines and expectations.
ESSENTIAL FUNCTIONS OF POSITION:
EDUCATION / REQUIREMENTS:
Is one of the following: A doctor of medicine osteopathy, a registered nurse, an individual who holds at least a bachelor’s degree in a professional category specified in the Federal regulation 483.430 paragraph (b)(5) or designated as a human services professional that has at least a bachelor’s degree in a human services field (including, but not limited to: sociology, special education, rehabilitation counseling, and psychology).
At least one year’s experience working with intellectual disabilities or other developmental disabilities.
When State licensure and/or certification is required for the professional degree held by the QIDP, the license must be current and unencumbered.
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