Medical Policy Manager jobs in Benton Harbor, MI

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)

T
Medical Director
  • Theoria Medical
  • Benton, MI FULL_TIME
  • Position TypeFull-time, exempt

    Compensation: Up to $400,000 annually monthly Medical Director Stipend

    Job Location: In person

    Job Highlights

    • Work-Life Balance: Competitive compensation with balanced hours.
    • Weekend & On-Call Freedom: No on-call, no weekends.
    • Always Supported: NP/PA support at all locations, always.
    • Pre-Screened Patient Interactions: Telemedicine and APP triage before physician contact.
    • Flexible Scheduling: Your schedule, tailored to fit your life. No set daily shift times.
    • No Overnight Duties: Sleep peacefully with no overnight call/requirements.
    • Effortless documentation: Conversational and Dragon dictation.
    • Meaningful Connections: Establish lasting relationships with patients and staff.
    • Culture of Appreciation: Your work is valued and rewarded.
    • $1,500 CME and Conference Allowance: Invest in your growth.
    • Full Gear: iPad with LTE, Apple Pen, AirPods provided.
    • Licensure Reimbursed: We cover your medical licensure costs.
    • Malpractice & Tail Covered: Full insurance peace of mind.
    • Benefits: 401k match, Medical/Dental/Vision, Disability, Employer-paid Life Insurance.
    • Relocation Help: Assistance for a smooth move.
    • Referral Bonus: Earn more by expanding our team.
    • Travel Reimbursed: Gas and mileage for work travel.
    • Career Advancement: Leadership opportunities promoted.
    • UpToDate Subscription: Latest medical info at your fingertips.

    Essential Functions & Responsibilities

    • The physician serves as medical director for skilled nursing facilities (SNF) and participates in administrative and quality initiatives for the facilities he or she is responsible for;
    • Medical directorship functions include attending and participating in monthly quality assurance and process improvement meetings; participating in quality improvement initiatives; providing guidance to facility staff; reviewing and revising (if necessary) facility’s clinical guidelines; insuring compliance with state and federal regulations, training facility staff; and supervising facility clinical staff.
    • In addition to the medical director role, the physician also serves as the attending physician for the residents residing at each facility;
    • The physician collaborates with Nurse Practitioners and Physician Assistants to manage day to day resident care at each facility. Typically, each facility will have a full-time PA or NP assigned to the facility depending on the acuity and volume of the patient population;
    • Physician will provide high quality, patient-centered, comprehensive primary care services by rounding on patients residing in SNFs;
    • Physician is responsible for diagnosing and treating patients with acute illness, such as bacterial and viral infections, as well as chronic diseases and conditions, such as hypertension, heart disease, or diabetes
    • Provider documentation is completed in Theoria’s proprietary electronic health record (EHR) system, ChartEasy™
    • PointClickCare, MatrixCare, and American HealthTech are the most commonly used facility EHR systems
    • Participating in Theoria’s Chronic Care Management, Transitional Care, RPM and other medical quality initiatives and programs
    • Physician must be able to supervise collaborating nurse practitioners and physicians assistants
    • Physician must be able to utilize electronic/online medical tools such as EHR systems and state/county medical systems utilized for Death Certificates and administrative functions.

    Company Overview

    Leading the charge in healthcare innovation, Theoria Medical offers a unique blend of medical excellence and technological advancement, primarily serving the post-acute and primary care sectors. Our extensive network includes multispecialty physician services, telemedicine, and RPM, covering skilled nursing facilities across the country. In our national push for expansion, we're scouting for the brightest nurse practitioners and physicians eager to drive change and deliver superior care. Join us for a rewarding career that promises professional growth, flexibility, and the chance to shape the future of healthcare.

    Shift Structure

    • Shifts are flexible depending on physicians’ schedule;
    • Typically, medical directors work a minimum of 2-3 days/week at each facility they oversee;
    • Rounding times are flexible with no set start and end time. Preferably, physicians start in the morning between 7-10 a.m. and finish their day when their caseload has been seen;
    • No nights, weekends, or on-call
    • Call is covered by Theoria’s telemedicine team
    • This is an in-person position

    Compensation and Benefits

    • Competitive compensation package, including Medical Director stipend
    • Compensation ranges approximately from $50,000-$400,000/year depending upon employment status and availability (PRN, Part-Time, Full-Time)
    • Employer Paid - Life Insurance Policy

     

    Employee must be able to perform the essential functions of this position satisfactorily, with or without a reasonable accommodation. Employer retains the right to change or assign other duties to this position. All benefits and job highlights are subject to and contingent upon availability.

     

    #LI-Onsite
    #LI-JT1
    #IND-MULTI

  • Just Posted

S
Medical Receptionist
  • South Shore Women's Medical Health Care
  • Saint Joseph, MI FULL_TIME
  • We are looking for a team member to enhance our patients' reception experience at our office. Previous office experience is very helpful, but not mandatory. Customer service skills are key to this rol...
  • 1 Month Ago

Z
Medical Device Sales - Benton Harbor, MI
  • Zynex Medical
  • Benton, MI OTHER
  • Job Details Level: Entry Job Location: Benton Harbor, MI - Benton Harbor, MI Position Type: Full Time Education Level: 2 Year Degree Salary Range: $55,000.00 Base Commission/year Job Shift: Day Job Ca...
  • 23 Days Ago

M
Medical Courier Job
  • Medical Courier Job Jobs Hiring
  • Covert, MI FULL_TIME
  • (Hiring Immediately) Part/Full-Time Medical Courier Job Jobs Available in Covert, MI. No Experience Required.
  • 26 Days Ago

M
Medical Courier Jobs
  • Medical Courier Jobs Jobs Hiring
  • Covert, MI FULL_TIME
  • (Hiring Immediately) Part/Full-Time Medical Courier Jobs Jobs Available in Covert, MI. No Experience Required.
  • 26 Days Ago

M
Medical Courier Job
  • Medical Courier Job Jobs Hiring
  • Breedsville, MI FULL_TIME
  • (Hiring Immediately) Part/Full-Time Medical Courier Job Jobs Available in Breedsville, MI. No Experience Required.
  • 26 Days Ago

Filters

Clear All

Filter Jobs By Location
  • Filter Jobs by companies
  • More

0 Medical Policy Manager jobs found in Benton Harbor, MI area

C
Dietitian and Culinary Instructor
  • Corewell Health
  • Benton Harbor, MI
  • Job Summary The Registered Dietitian's primary responsibilities include direct patient care through application of the N...
  • 4/25/2024 12:00:00 AM

E
Mobility Transportation Driver
  • Emergent Health Partners
  • Benton Harbor, MI
  • Lifecare Ambulance is hiring part-time drivers for our Mobility Transportation Services/PACE transportation program in B...
  • 4/25/2024 12:00:00 AM

K
KFC Restaurant General Manager
  • KFC
  • Benton Harbor, MI
  • Looking for a rewarding career in the fast-food industry? KBP Foods, a leading franchisee of KFC, is hiring a Restaurant...
  • 4/25/2024 12:00:00 AM

A
Retail Sales Associate (Part-Time)
  • AutoZone, Inc.
  • Benton Harbor, MI
  • AutoZone's Part-Time Retail Sales Associates drive sales through superior customer service by exceeding customer expecta...
  • 4/25/2024 12:00:00 AM

E
Hardware Engineer
  • eInfochips (An Arrow Company)
  • Benton Harbor, MI
  • Role: This is reference to Wire Harness engineer (3+ years of experience in Wiring Harness Product Development Engineeri...
  • 4/23/2024 12:00:00 AM

C
Dietitian and Culinary Instructor
  • Corewell Health
  • Benton Harbor, MI
  • Job Summary The Registered Dietitian's primary responsibilities include direct patient care through application of the N...
  • 4/23/2024 12:00:00 AM

H
Locum Tenens Nurse Practitioner - Psychiatry - $80 per hour
  • Hiring Now!
  • Saint Joseph, MI
  • Jackson and Coker is seeking a Nurse Practitioner Psychiatry for a locum tenens job in Saint Joseph, Michigan. Job Descr...
  • 4/22/2024 12:00:00 AM

D
Vehicle Inspector and Photographer
  • Dominion Enterprises
  • Benton Harbor, MI
  • Dealer Specialties is looking for a Vehicle Inspector to join our dynamic team. We offer a desirable work environment th...
  • 4/22/2024 12:00:00 AM

Benton Harbor is a city in Berrien County in the U.S. state of Michigan which is located southwest of Kalamazoo, and northwest of South Bend, Indiana. In 2010, the population was 10,038 according to the census. It is the smaller, by population, of the two principal cities in the Niles–Benton Harbor Metropolitan Statistical Area, an area with 156,813 people. Benton Harbor and the city of St. Joseph are separated by the St. Joseph River and are known locally as the "Twin Cities".[not in citation given] Fairplain and Benton Heights are unincorporated areas adjacent to Benton Harbor. According to...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Manager jobs
$126,527 to $154,464
Benton Harbor, Michigan area prices
were up 1.3% from a year ago

Medical Policy Manager in Casper, WY
The Medical Policy Portal offers streamlined navigation to the various types of policies available.
February 14, 2020
Medical Policy Manager in Saint Paul, MN
The expanded policy, called the Air Force Memorandum for Appearance and Accession Standards Review, gives applicants with previously disqualifying medical conditions a second chance on a case-by-case basis.
February 12, 2020
Medical Policy Manager in Atlantic City, NJ
Get the latest updates to Blue Cross NC's medical policies.
January 14, 2020