Medical Policy Manager jobs in Billings, MT

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)

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Medical Director
  • Theoria Medical
  • Billings, MT FULL_TIME
  • Position TypePart-time, exempt

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

    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.

     

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  • 26 Days Ago

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Clinic Manager West End Walk in Clinic
  • SCL Health Medical Group - Billings
  • Billings, MT FULL_TIME
  • You. You bring your body, mind, heart and spirit to your work as a Practice Manager supporting our OBGYN, Urology, Med Onc Clinics. Your compassion is tangible: patients feel it in the hand they hold....
  • 1 Month Ago

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Nurse Manager – Vascular Surg/Medical PCU
  • Jobs for Humanity
  • Cooke, MT CONTRACTOR,FULL_TIME
  • Job Description Why Mayo Clinic Mayo Clinic is ranked highest in more areas of expertise than any other healthcare provider according to U.S. News & World Report. As we work together to prioritize the...
  • 18 Days Ago

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Medical Surgical Registered Nurse
  • WorldWide Medical Staffing
  • Billings, MT FULL_TIME
  • Worldwide Medical is a Native-American-Veteran-owned Staffing Firm. We specialize in Government Hospital contracts and are actively seeking Registered Nurses for a Medical/Surgical setting near Billin...
  • 1 Day Ago

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Registered Nurse - Medical Surgical
  • Worldwide Medical Staffing
  • Crow Agency, MT FULL_TIME
  • Worldwide Medical is a Native American & Veteran-owned Staffing Firm. We specialize in Government Hospital contracts and are actively seeking Registered Nurses for a Medical / Surgical setting near Bi...
  • 3 Days Ago

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Medical Surgical Registered Nurse
  • Worldwide Medical Staffing
  • Crow Agency, MT FULL_TIME
  • Worldwide Medical is a Native American & Veteran-owned Staffing Firm. We specialize in Government Hospital contracts and are actively seeking Registered Nurses for a Medical / Surgical setting near Bi...
  • 11 Days Ago

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0 Medical Policy Manager jobs found in Billings, MT area

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Remote Licensed Psychiatrist
  • Headway
  • Billings, MT
  • Remote Licensed Psychiatrist Wage: Between $148-$239 an hour Are you a licensed Psychiatrist looking to launch a private...
  • 4/26/2024 12:00:00 AM

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Remote Licensed Marriage and Family Therapist
  • Headway
  • Billings, MT
  • Remote Licensed Marriage and Family Therapist (LMFT) Wage: Between $95-$122 an hour Are you a Licensed Marriage and Fami...
  • 4/26/2024 12:00:00 AM

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Remote Licensed Mental Health Counselor
  • Headway
  • Billings, MT
  • Remote Licensed Mental Health Counselor (LMHC) Wage: Between $95-$122 an hour Are you a Licensed Mental Health Counselor...
  • 4/26/2024 12:00:00 AM

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Remote Licensed Clinical Psychologist
  • Headway
  • Billings, MT
  • Remote Licensed Clinical Psychologist Wage: Between $95-$174 an hour Are you a Licensed Clinical Psychologist looking to...
  • 4/26/2024 12:00:00 AM

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Medical Director for The Rehabilitation Hospital of Montana
  • Rehabilitation Hospital Of Montana
  • Billings, MT
  • Description Lifepoint Rehabilitation Services is dedicated to Hope, Healing, and Recovery for our patients. We are in pa...
  • 4/26/2024 12:00:00 AM

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Remote Licensed Clinical Social Worker
  • Headway
  • Billings, MT
  • Remote Licensed Clinical Social Worker (LCSW) Wage: Between $95-$122 an hour Are you a Licensed Clinical Social Worker l...
  • 4/26/2024 12:00:00 AM

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Remote Licensed Professional Counselor
  • Headway
  • Billings, MT
  • Remote Licensed Professional Counselor (LPC) Wage: Between $95-$122 an hour Are you a Licensed Professional Counselor lo...
  • 4/26/2024 12:00:00 AM

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Remote Licensed Psychiatric Nurse Practitioner
  • Headway
  • Billings, MT
  • Remote Licensed Psychiatric Nurse Practitioner Wage: Between $148-$203 an hour Are you a licensed Psychiatric Nurse look...
  • 4/26/2024 12:00:00 AM

Billings is the largest city in the U.S. state of Montana, with a population estimated at 109,642 as of 2017. Located in the south-central portion of the state, it is the seat of Yellowstone County and the principal city of the Billings Metropolitan Area, which has a total a population of 170,498. It has a trade area of over 500,000. Billings was nicknamed the "Magic City" because of its rapid growth from its founding as a railroad town in March 1882. The city is named for Frederick H. Billings, a former president of the Northern Pacific Railroad. With one of the largest trade areas in the Uni...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Manager jobs
$126,658 to $154,624
Billings, Montana area prices
were up 3.1% from a year ago

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