Medical Policy Manager manages and implements corporate policy and process for medical provider and other reimbursements. Ensures that all claims are reviewed, settled, and processed in compliance with and according to contract provisions and regulatory requirements. Being a Medical Policy Manager evaluates and develops policies and provider reimbursement guidelines to effectively manage and control medical claims cost. Requires a bachelor's degree of finance, business or healthcare administration. Additionally, Medical Policy Manager typically reports to head of a unit/department. The Medical Policy 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 Policy 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)
Description:
Administrative, Leadership, & Managerial Skills
Marketing & Public Relations
Financial Skills
Must possess the appropriate level of skill and knowledge as a Medical Technologist
Must possess extensive technical knowledge and skills in the area of specialization or the laboratory department
Must have the ability to perform technical level benchwork, including problem-solving and troubleshooting performance as needed to maintain workflow
Must possess adequate skills for the collection and handling of statistical data, and for quality assurance concepts Must have the ability to effectively communicate verbally and in writing and to implement written and oral instructions
Must have a high degree of integrity, initiative, and self-organization
Must have the ability to research, assimilate and implement new technical procedures, including a reasonable level of knowledge regarding current testing procedures and instrumentation, and the ability to make recommendations for such procedures and instrumentation
Must possess the ability to train, maintain competency, and evaluate all personnel within the department/area/laboratory supervised
Must be able to apply budgetary, inventory control, and personnel management concepts as related to the department/area/laboratory supervised
Must have the ability to cover call for technical and personnel problems
Education/Experience:
Bachelor of Science degree in Medical Technology, Biology or Chemistry required Or Master's Degree in the area of specialization
Certification: Certification by ASCP or other nationally recognized certification agency (acceptability of the certifying agency to be determined by the Administrative Director)
Maintenance of certification is strongly encouraged during employment with John D. Archbold Medical Center
A minimum of three years experience as a Medical Technologist
As deemed necessary to be in accordance with certification by the Georgia Department of Human Resources
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