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)
Who We Are:
People are our passion and purpose. Conemaugh Health System, of Duke LifePoint Healthcare, is the largest healthcare provider in west central Pennsylvania, serving over a half-million patients each year through the Conemaugh Physician Group and Medical Staff, a network of hospitals, specialty clinics and patient focused programs. Conemaugh Health System employs over 5,000 clinical and non-clinical staff, and over 450 physicians committed to providing the ideal patient experience.
Where We Are:
The city of Johnstown is home to high-performing schools and safe, affordable neighborhoods that make working, living and raising a family special. There are many opportunities for educational advancement including the University of Pittsburgh at Johnstown, Saint Francis University, and Mount Aloysius College.
Why Choose Us:
* Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
* Competitive Paid Time Off / Extended Illness Bank package for full-time employees
* Employee Assistance Program - mental, physical, and financial wellness assistance
* Tuition Reimbursement/Assistance for qualified applicants
* Professional Development and Growth Opportunities
* And much more...
Position Summary:
The primary responsibilities of the Practice Manager include maintenance of the daily operations and general management of the practice(s). This job also involves developing educational planning programs, allocating and assigning duties to employees, and monitoring the activities and operations of all the practice(s) components to ensure the practice(s) meets its objectives.
Minimum Qualifications:
REQUIRED: High School graduate or equivalent; College Degree or Certified Practice Manager; At least 5 to 10 years of management experience in a healthcare environment; CPR or acquired within 2 months of hire.
PREFERRED: At least 5 years of office practice management experience; Valid PA Registered Nurse License.
EEOC Statement:
Conemaugh Health System is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.
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