Medical Policy Manager jobs in Norfolk, VA

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 Case Manager
  • Eastern Virginia Medical School
  • Norfolk, VA FULL_TIME
  • Overview

    This is a full-time position for a licensed social worker with medical case management experience and a strong desire to work in a hospital setting, as well as an outpatient setting. Must be empathetic, and an organized individual with excellent communication and prioritization skills, who has a high interest in healthcare. The Medical Case Manager will provide direct hospital and outpatient care coordination for our patients and assist our physicians to meet emerging quality metrics. The Medical Case Manager’s role is to liaison with a patient, their family, and the patient's healthcare providers to coordinate medical and community resources in order to improve patient health outcomes.

    Responsibilities

    • Serve as a resource for the extension of care provided to our patients with multiple social determinants of health and chronic diseases.
    • Observe, receive, and seek out information from all relevant sources to assist patients.
    • Collaborate with other professionals to meet patient needs, develop, share, and maintain a list of community and social service programs, and refer individuals as appropriate.
    • Actively participate with the quality goals of the practice as assigned.
    • Work independently to develop the role by analyzing information, evaluating results, and finding solutions that will improve practice outcomes.
    • Be assigned to other care management team duties that include direct patient involvement, data entry, database management, and patient quality initiatives. This may include, but is not limited to; Transitional Care Management, emergency department utilization, high risk patient management, payer initiatives, and EVMS Medical Group goals.
    • Serve as a resource for staff and providers.
    • Performs other duties as assigned

     

    SECONDARY DUTIES AND RESPONSIBILITIES:

    • Scan upcoming appointments for additional medical records, appointments, and information as necessary. Obtain medical records from other physician offices, hospitals, labs, emergency rooms, and radiology departments prior to patient visit.
    • Complete all “tasks” assigned to the individual, and the team, within their scope of training and licensing regulations.
    • Respond to questions from patients, family members, faculty/residents, other health care providers in a timely and professional manner.
    • In their role as a team member for the quality initiatives of the practice, the Case Manager may also administer and collect patient satisfaction surveys and contact patients between visits to assess medical needs and adherence.
    • Participate in all staff meetings, education lectures, and quality improvement activities.
    • Follow EVMS protocols related to infection control, environmental safety and patient confidentiality. Complete annual recertification for OSHA, Blood Borne Pathogens, Compliance, Respiratory FIT and IT policy. Maintain current CPR certification and LBSW license.

    Qualifications

    Bachelor of Social Work (BSW).  Current, unencumbered licensure as a Licensed Baccalaureate Social Worker (LBSW).  Two (2) years of social work and/or case management experience required. 

    Experience with the MS Office Suite of products, including Excel.

    EHR experience a plus.

     

    KNOWLEDGE, SKILLS AND ABILITIES:

    Eager to learn more about the social and medical support requirements of our practice population.

    Personal interest in health and wellness that will inform patient education for lifestyle choices.

    Critical thinking, prioritization, and organization skills that contribute to improving patient outcomes.

    Location : Location

    US-VA-Norfolk
  • 19 Days Ago

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Policy & Procedure Administrator
  • ABNB Federal Credit Union
  • Chesapeake, VA FULL_TIME
  • Employee Perks Employee Benefits (401k plans and match opportunities / Company paid Short-Term and Long-Term Disability / Tuition reimbursement / Affordable health insurance options) Competitive compe...
  • 13 Days Ago

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Medical Office Manager I
  • Tidewater Physicians Multispecialty Group P C
  • Chesapeake, VA FULL_TIME
  • Position Summary The Medical Office Manager I is responsible for the daily operations of the location. Provides staff and operations support for the office in which they are assigned. Promotes a posit...
  • 19 Days Ago

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Medical Office Manager I
  • Greenbrier
  • Chesapeake, VA FULL_TIME
  • Position Summary The Medical Office Manager I is responsible for the daily operations of the location. Provides staff and operations support for the office in which they are assigned. Promotes a posit...
  • 1 Month Ago

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Medical Office Manager I
  • TIDEWATER PHYSICIANS MULTISPECIALTY GROUP P C
  • Chesapeake, VA OTHER
  • Job Details Job Location: Greenbrier Family Medicine and TMC Greenbrier - Chesapeake, VA Position Type: Full Time Salary Range: Undisclosed Job Category: Administrative Support DescriptionPosition Sum...
  • 1 Month Ago

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Manager I, Scholarships
  • Eastern Virginia Medical School
  • Norfolk, VA FULL_TIME
  • Overview Scholarship Manager shall have the primary responsibility to manage the student scholarship application process for the awarding of EVMS scholarship funds, outside scholarships and state gran...
  • 23 Days Ago

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0 Medical Policy Manager jobs found in Norfolk, VA area

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Pharmacist, Third-Shift, 7on 7off
  • Bon Secours Mercy Health
  • Portsmouth, VA
  • At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectivenes...
  • 3/28/2024 12:00:00 AM

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Remote Licensed Clinical Psychologist
  • Headway - Design & Development
  • Virginia Beach, VA
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 3/27/2024 12:00:00 AM

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Remote Licensed Clinical Psychologist
  • Headway - Design & Development
  • Chesapeake, VA
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 3/27/2024 12:00:00 AM

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Medical Receptionist( Mental Health office)
  • Eccentric Minds Health & Wellness PLLC
  • Newport News, VA
  • Job Description Job Description *$500 sign on bonus *Only applicants who have completed both job assessments with the ap...
  • 3/27/2024 12:00:00 AM

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Adult Psychiatrist - Outpatient
  • LifeStance Health
  • Chesapeake, VA
  • At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make liv...
  • 3/26/2024 12:00:00 AM

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Child Adolescent Psychiatrist - Outpatient
  • LifeStance Health
  • Chesapeake, VA
  • At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make liv...
  • 3/26/2024 12:00:00 AM

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Pharmacist PRN
  • Bon Secours Mercy Health
  • Portsmouth, VA
  • Thank you for considering a career at Bon Secours Mercy Health! Primary Function/General Purpose of Position The Pharmac...
  • 3/25/2024 12:00:00 AM

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Psychiatric Nurse Practitioner (PMHNP)
  • LifeStance Health
  • Newport News, VA
  • At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make liv...
  • 3/24/2024 12:00:00 AM

According to the United States Census Bureau, the city has a total area of 96 square miles (250 km2), of which 54 square miles (140 km2) is land and 42 square miles (110 km2) (43.9%) is water. Norfolk is located at 36°55′N 76°12′W / 36.917°N 76.200°W / 36.917; -76.200 (36.8857° N, 76.2599° W) The city is located at the southeastern corner of Virginia at the junction of the Elizabeth River and the Chesapeake Bay. The Hampton Roads Metropolitan Statistical Area (officially known as the Virginia Beach-Norfolk-Newport News, VA-NC MSA) is the 37th largest in the United States, with an estimated...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Manager jobs
$122,940 to $150,088
Norfolk, Virginia area prices
were up 1.2% from a year ago

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