Medical Policy Manager jobs in Carson City, NV

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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Manager - Cancer Care Services
  • WASHOE BARTON MEDICAL CLINIC
  • Gardnerville, NV FULL_TIME
  •  

    Manager - Cancer Care Services

    RETENTION BONUS - $15,000.00!!

    RELOCATION ASSISTANCE AVAILABLE

    POSITION SUMMARY:

    Under the direction of the Chief Nursing Officer, the nurse manager has 24-hour responsibility for the effective implementation of the philosophy, goals, policies, and procedures of the hospital and the nursing department and their effect on patient care in a designated unit. The nurse manager must have the ability to be a change agent and provide staff development and act as a clinical resource for their department. The manager will have the authority to make decisions on that unit in the areas of patient care, human resource, and financial management.


    POSITION REQUIREMENTS:

    Minimum Education

    • BSN required.

    License Required

    • Current Nevada RN license.

    Certifications Required

    • BLS certification.

    Certification Preferred

    • ONS/ONCC Oncology Nursing Society Chemotherapy Immunotherapy Certificate or willing to complete within 6 months.

    Minimum Work Experience

    • Demonstrated clinical competence in relevant area of nursing practice.
    • Demonstrated leadership ability and potential managerial competency.
    • Evidence of this includes, but is not limited to, effective communication skills, ability to deal well with people, ability to problem solve, ability to confront/resolve issues, ability to motivate others, ability to plan, organize, and direct the activities of others.


    POSITION ESSENTIAL FUNCTIONS:

    Staff

    • Ensure that new employees and other designated individuals have attended general hospital orientation as required.
    • Ensure staff members have completed and/ or maintained competencies and any licensing/ certification as designated by their job description.
    • Evaluations are completed within Human Resource policy guidelines.
    • Staff counseling, complete with opportunities for improvement, are done on a timely basis and in a professional manner in conjunction with HR.
    • Ensure all staff understands the culture and history of our organization as well as the strategic goals for the future.

    Management

    • Monitors trends and recommends staffing adjustments based on them. Manages hours worked, including overtime for all unit personnel.
    • Monitors and controls salary and wages budget.
    • Analysis of variance is completed in terms of rate and volume.
    • Recommendations regarding changes of products/par levels reflect cost, quality, and standardization.
    • Projects and recommends capital equipment needs for the unit and provides back up documentation and justification.
    • Defines performance objectives for the department and assesses the level of competence of staff in a timely manner.
    • Incorporates quality improvement data and/or patient satisfaction data into departmental goals.
    • Demonstrates a clear understanding of regulations applicable to patient care and/or other department functions.
    • Oversees unit CQI program which monitors and evaluates critical aspects of care.

    Patient Care

    • Assesses and diagnoses patient and family needs in order to provide quality care to assigned patients.
    • Performs admission assessment upon admission or in accordance with specific unit standards.
    • Identifies and documents patient needs and treatment plan upon admission.
    • Identifies patient’s requiring IV therapies that are high risk, and will require long-term therapy or who have other critical IV-related needs.
    • Identifies and documents patient/family/significant other teaching needs relative to IV therapy upon admission and as needed.

    Treatment Plan

    • Develops, discusses, and communicates a realistic treatment plan for each patient, in collaboration with each patient/family/significant other in order to address all identified needs.
    • Develops a preliminary plan for meeting IV therapy needs of the identified patient, including those with special needs.
    • Treatment plan will include recommendations for IV access, placement and maintenance.
    • Collaborates with the physician to ensure the treatment is implemented and carried out successfully.
    • Reassessment of effectiveness of treatment plan and interventions performed with every patient visit.
    • Assesses the patient/significant other's response to teaching plan in order to evaluate the effectiveness of the plan.

    Judgment

    • Demonstrates knowledge of commonly used meds: action, dose, and side effects.
    • Demonstrates proper procedures in all methods of medication administration, including infusion therapy.
    • Demonstrates problem solving skills through knowledge, research, and practice.
    • Demonstrates knowledge of hospital policies and procedures for administering, transcribing, and recording medications.
    • Demonstrates knowledge of hospital policies and procedures for transfusion of blood and blood products.
    • Observes 10 rights of medication administration: right med, right dose, right time, right route, right patient, right education, right documentation, right to refuse, right assessment, right evaluation.
    • Administers blood and blood products following hospital policy and procedures.
    • Initiates and maintains IV access according to hospital policy and procedures.
    • Assesses and documents IV site per unit standard.

    Documentation

    • Maintains up-to-date and accurate documentation of nursing care provided to ensure the integration of information for use by the healthcare team to ensure quality care.
    • Nursing assessment is complete and accurate at time of admission or per units/ service standard.
    • Nursing documentation is reflected in the integrated progress notes with an entry made per unit standard and when reassessment of the patient requires.
    • Nursing documentation reflects current plan for the patient and update.
    • All PICC insertions and removals are documented fully on the proper documentation, including catheter Information and verification of placement.

    Scope of Service

    • Performs all responsibilities/duties required by unit as defined in the scope of service, to ensure that the unique nature of the client is addressed. This includes, but is not limited to the age of the client served.
    • Assesses, evaluates, and carries out nursing interventions and teaching in chemotherapy patients, and patients receiving transfusions and IV therapy including phlebotomies.
    • Demonstrates skill and knowledge in nursing management of emergency situations.
    • Demonstrates knowledge and skill in use of special equipment such as pumps, blood transfusion equipment, Dynamap, cardiac monitor defibrillator.
    • Demonstrates knowledge and skill in specific areas of infusion therapy.
    • Demonstrates knowledge and understanding of IV management requirements for problem-prone IV medications.
    • Demonstrates knowledge and skill in placement of all types of peripheral IV devices.
    • Demonstrates knowledge and skill in all aspects of PICC line management.
    • Demonstrates knowledge and skill in assessment and management of all intravascular IV lines.


    BENEFITS:

    • RETENTION BONUS - $15,000.00!!
    • RELOCATION ASSISTANCE AVAILABLE
    • NO STATE INCOME TAX
    • Hometown Health Medical, EyeMed Vision, Guardian Dental, Vanguard 401(k) with match and Flexible Spending Account.
    • Employer paid Care Flight Membership for your household (A Division of REMSA).
    • Employer Paid Basic Life and AD&D insurance.
    • Unum Supplemental Insurance (Critical Illness, Accident, Short Term & Long Term Disability).
    • Earned Time Off, Sick Leave and Paid Holidays.
    • Nevada 529 College Fund.
    • Unum Employee Assistance Program.
    • Employer paid Credit monitoring and Identity Theft Program through CyberScout.
    • Tuition Reimbursement, Clinical Ladder* & HRSA Loan Repayment Program* (*for qualifying positions).
    • and More...

    CARSON VALLEY HEALTH IS PROUD TO BE RECOGNIZED AS A FINALIST IN THE

    "BEST PLACES TO WORK" - NORTHERN NEVADA, 2021 & 2022!

    WE LOOK FORWARD TO WELCOMING YOU TO OUR TEAM!!

  • 2 Months Ago

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SUPERVISORY IT SPECIALIST (POLICY AND PLANNING)
  • U.S. Marine Corps
  • Bridgeport, CA FULL_TIME
  • This is a public notice flyer to notify interested applicants of anticipated vacancies. Applications will not be accepted through this flyer. Interested applicants must follow the directions in the "H...
  • 21 Days Ago

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Medical Assistant - Family Medicine
  • Carson Medical Group
  • Carson, NV FULL_TIME
  • JOB DETAILS: Join us as we move to out beautiful new facility opening May 2024. Carson Medical Group is seeking a Certified or Registered Medical Assistant to join our amazing team. Carson Medical Gro...
  • 1 Month Ago

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Medical Device Sales - Paid Internship
  • Medical Sales College
  • Pollock Pines, CA FULL_TIME
  • DescriptionMedical Device Sales - Paid InternshipLooking for a rewarding and lucrative career in the medical sales industry? Our paid Internship may be the right path for you!Here are just some of the...
  • 4 Days Ago

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Medical Device Sales - Paid Internship
  • Medical Sales College
  • South Lake Tahoe, CA FULL_TIME
  • DescriptionMedical Device Sales - Paid InternshipLooking for a rewarding and lucrative career in the medical sales industry? Our paid Internship may be the right path for you!Here are just some of the...
  • 15 Days Ago

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Medical Assistant - Senior Care - Full Time
  • WASHOE BARTON MEDICAL CLINIC
  • Gardnerville, NV FULL_TIME
  • Medical Assistant - Senior Care - Full Time RETENTION BONUS - $3,000.00!!POSITION SUMMARY:Provide comfortable, safe and professional care for the clinic patient, infant through geriatric. Maintain an ...
  • 8 Days Ago

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0 Medical Policy Manager jobs found in Carson City, NV area

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Software Engineer, Camera Driver - Reality Labs
  • Facebook
  • Carson City, NV
  • Summary: Facebook is seeking a data center Critical Facility Engineer to join our Data Center Facility Operations team. ...
  • 5/7/2024 12:00:00 AM

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Service Advisor
  • Michael Hohl Automotive Group
  • Carson City, NV
  • At Michael Hohl Automotive Group, we value our employees and we treat them like family. Each team member can take advant...
  • 5/6/2024 12:00:00 AM

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Crew Member
  • Chipotle
  • Carson City, NV
  • Crew Member (24011340) Description CULTIVATING A BETTER WORLD Food served fast doesn't have to be a typical fast food ex...
  • 5/6/2024 12:00:00 AM

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Field Network Support Engineer (West Coast)
  • BAXTER
  • Carson City, NV
  • This is where you save and sustain lives At Baxter, we are deeply connected by our mission. No matter your role at Baxte...
  • 5/6/2024 12:00:00 AM

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Fleet (Route) Maintenence Supervisor
  • Penske
  • Carson City, NV
  • Responsibilities As a Penske Maintenance Supervisor you will use your excellent communication, organization, and multita...
  • 5/4/2024 12:00:00 AM

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Auto Detailer
  • Michael Hohl Automotive Group
  • Carson City, NV
  • At Michael Hohl Automotive Group, we value our employees and we treat them like family. Each team member can take advant...
  • 5/4/2024 12:00:00 AM

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CDL-A OTR Team Drivers - Top Team Pay + Great Benefits
  • U.S. Xpress
  • Carson City, NV
  • U.S. Xpress is Now Hiring CDL-A OTR Team Drivers! CDL-A Teams: Top Team Pay in the Nation & Up To $15,000 Sign-On Bonus/...
  • 5/4/2024 12:00:00 AM

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Software Engineer, Machine Learning Specialist- PyTorch Open Source
  • Facebook
  • Carson City, NV
  • Summary: Facebook is seeking a data center Critical Facility Engineer to join our Data Center Facility Operations team. ...
  • 5/4/2024 12:00:00 AM

Carson City is an independent city and capital of the US state of Nevada, named after the mountain man Kit Carson. As of the 2010 census, the population was 55,274. The majority of the town's population lives in Eagle Valley, on the eastern edge of the Carson Range, a branch of the Sierra Nevada, about 30 miles (50 km) south of Reno. The town began as a stopover for California-bound emigrants, but developed into a city with the Comstock Lode, a silver strike in the mountains to the northeast. The city has served as Nevada's capital since statehood in 1864; for much of its history it was a hub ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Manager jobs
$131,941 to $161,068
Carson City, Nevada area prices
were up 2.5% from a year ago

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