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)
Work within the nursing process to provide direct nursing care to assigned patients consistent with clinical specialty (PCU/ICU/ED etc.), Serve as a role model to promote a positive work environment and quality patient care.
Ensure adherence to Hospitals and departmental policies and procedures. Minimum work requirement for RN Per Diem I is two shifts per schedule. One weekend shift per schedule and one summer and one winter holiday are required. Patient care assignment may include; Neonate, Pediatric, Adolescent, Adult and Geriatric age groups.