Medical Policy Manager jobs in Chattanooga, TN

Description

Responsible for the daily operation and maintenance of small to medium clinic practice(s) generally comprised of up to approximately 4-7 physicians, supervision of staff members, implementation of cost control measures, monitoring and adherence to patient care quality standards, problem resolution, and all duties to ensure efficient and effective clinic operation. Directs, supervises and coordinates staff and activities at assigned clinic to ensure the delivery of quality patient service. This position ensures staff complies with all legal and regulatory standards. Ensures clinic adherence with and policies and procedures.

Requirements

Essential Job Functions

• Oversight of the planning, organization and direction of clinic operations.
• Provides supervision, development and mentoring, evaluation and management of clinic supervisory staff.
• Monitors compliance of all clinic metrics (Customer Service, Membership, Retention, etc).
• Assists in the preparation, implementation and adherence to clinic budgets.
• Ensures region is well promoted and properly represented through marketing and community relations.
• Provides continual process improvement including all clinic processes and/or services.
• Supervises assigned personnel to ensure quality patient care, including forms and procedures as required.
• Monitors clinic workflow and schedule to ensure productivity standards are met.
• Administers clinic policies and procedures in a consistent and timely manner.
• Evaluates performance and recommends merit increases, promotions, and disciplinary actions, assists in interviews, trains, and orients staff.
• Ensures that office space, supplies, assistance are provided and maintained appropriately for medical staff and patient care
• Works with senior management to ensure operations and relations are effective
• Attends required meetings and participates in committees as requested.
• Ensures personnel forms and/or records are kept updated and submitted to other departments in a timely manner.
• Ensures that offices for new and incoming providers are ready and equipped.
• Collects clinic performance and quality metrics and produces reports for management.
• Orders office and medical supplies and ensures sufficient quantities are maintained at all times.
• Assists in budget preparation and adherence.
• Performs all other related duties as assigned

Minimum Required Education, Experience & Skills

• Associate's Degree required. Bachelor’s Degree preferred, or a minimum of 3 years of demonstrated management experience in a healthcare setting
• Familiar with fiscal and human resource management practices
• Knowledge of health care administration principles, including managed care, insurance claims processes, medical terminology, etc.
• Skill in gathering, analyzing and interpreting information
• Familiar with fiscal management and human resource management practices
• Proficiency with computer systems, programs and applications
• Knowledge of health care administration principles, including managed care, insurance claims processes, medical terminology, etc
• Ability to apply principles to solve everyday problems in a variety of situations
• Knowledge of fiscal management and human resource management techniques
• Knowledge of office management techniques and practices
• Skill in written and verbal communication
• Ability to exercise initiative, problem solving, decision-making
• Ability to establish priorities and coordinate work activities
• Good communication and customer service skills

Preferred Education, Experience & Skills

• Five or more years of clinical supervisory experience
• Bilingual (English/Spanish) fluency preferred

Physical & Mental Requirements:

• Ability to lift up to 50 pounds
• Ability to push or pull heavy objects using up to 50 pounds of force
• Ability to sit for extended periods of time
• Ability to stand for extended periods of time
• Ability to use fine motor skills to operate office equipment and/or machinery
• Ability to receive and comprehend instructions verbally and/or in writing
• Ability to use logical reasoning for simple and complex problem solving
• Ability to travel to multiple locations to support business needs as required