Medical Policy Manager jobs in Pennsylvania

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 Research Project B (Department of Medical Ethics & Health Policy)
  • University of Pennsylvania
  • Philadelphia, PA FULL_TIME
  • University Overview

    The University of Pennsylvania, the largest private employer in Philadelphia, is a world-renowned leader in education, research, and innovation. This historic, Ivy League school consistently ranks among the top 10 universities in the annual U.S. News & World Report survey. Penn has 12 highly-regarded schools that provide opportunities for undergraduate, graduate and continuing education, all influenced by Penn's distinctive interdisciplinary approach to scholarship and learning. As an employer Penn has been ranked nationally on many occasions with the most recent award from Forbes who named Penn one of America's Best Employers By State in 2021.

    Penn offers a unique working environment within the city of Philadelphia. The University is situated on a beautiful urban campus, with easy access to a range of educational, cultural, and recreational activities. With its historical significance and landmarks, lively cultural offerings, and wide variety of atmospheres, Philadelphia is the perfect place to call home for work and play.

    The University offers a competitive benefits package that includes excellent healthcare and tuition benefits for employees and their families, generous retirement benefits, a wide variety of professional development opportunities, supportive work and family benefits, a wealth of health and wellness programs and resources, and much more.

    COVID-19 vaccination is a requirement for all positions at the University of Pennsylvania. New hires are expected to be fully vaccinated before beginning work at the University. For more information about Penn's vaccine requirements, visit the Penn COVID-19 Response website for the latest information.

    Posted Job Title
    Manager Research Project B (Department of Medical Ethics & Health Policy)

    Job Profile Title
    Manager Research Project B

    Job Description Summary
    Responsible for both strategic planning and day to day management of complex and broad range of projects conducted with collaborators both internal and external to University. Take leadership role in developing study protocols, writing grants, managing the detailed operations of projects, analyzing qualitative and quantitative data, cultivating close relationships with community partner organizations, and drafting/editing manuscripts for submission to peer-reviewed journal.

    Job Description

    Faculty in the Department of Medical Ethics and Health Policy in the Perelman School of Medicine are engaged in innovative and ground breaking research, both domestically and internationally. This position will provide project management support to a research portfolio, led by a faculty member in the Department of Medical Ethics and Health Policy. The Project Manager B (PM-B) will be responsible for managing day-to-day operations for data research projects and innovative behavioral research projects within the Division of Health Policy. The projects this PM will manage are in partnership with external stakeholders (e.g., payors, providers). In this role, the PM will work hand-in-hand with the PI and external partner project teams to design and implement study scope of works (SOWs). The PM will function as the day-to-day manager of the research projects including communicating with external stakeholders, overseeing the development of study protocols, coordinating regulatory approval from the institutional review board (IRB), managing data requests and agreements/proposals, organizing study data collection, overseeing the budgets/grant expenditures/cash flow, managing subcontracts, overseeing study staff and coordination of team meetings including coordinating activities of the project data collection teams and the statistical programming team; monitoring progress and timelines, preparing materials for interim reports, contributing to manuscript preparation and presentation; and addressing interim problems as they arise.

    We are profoundly committed to diversity, equity and inclusion and we are seeking candidates who foster and support this commitment.

    Qualifications

    A Master's degree and 3 to 5 years of experience in a health-related field or an equivalent combination of education and experience required.

    This person should have an understanding of the healthcare system and a desire to expand this knowledge base. The successful candidate will be extremely well organized and resourceful. The project manager must be quantitatively and analytically skilled, thrive in multi-tasking environments, and be a self-starter with a results orientation. Strong PC skills in Microsoft Office including Excel, Word, and Powerpoint is required. The project manager will interact with a variety of faculty members, staff, external partners, and students throughout the university, so strong interpersonal communication skills are essential. High accuracy, dependability, and attention to detail will be vital to success in the position. The project manager should have the ability to work independently and as part of a team.

    Position contingent upon funding.

    Job Location - City, State
    Philadelphia, Pennsylvania
    Hybrid Eligible - This position is eligible for a hybrid work schedule with a work week divided between working onsite and working remotely.

    Department / School
    Perelman School of Medicine

    Pay Range
    $61,046.00 - $95,972.00
    Salary offers are made based on the candidate's qualifications, experience, skills, and education as they directly relate to the requirements of the position, as well as internal and market factors and grade profile.

    Affirmative Action Statement
    Penn adheres to a policy that prohibits discrimination on the basis of race, color, sex, sexual orientation, gender identity, religion, creed, national or ethnic origin, citizenship status, age, disability, veteran status, or any other legally protected class.

    Special Requirements
    Background check required after a conditional job offer is made. Consideration of the background check will be tailored to the requirements of the job.

    University Benefits

    Health, Life, and Flexible Spending Accounts : Penn offers comprehensive medical, prescription, behavioral health, dental, vision, and life insurance benefits to protect you and your family's health and welfare. You can also use flexible spending accounts to pay for eligible health care and dependent care expenses with pre-tax dollars.

    Tuition : Take advantage of Penn's exceptional tuition benefits. You, your spouse, and your dependent children can get tuition assistance here at Penn. Your dependent children are also eligible for tuition assistance at other institutions.

    Retirement: Penn offers generous retirement plans to help you save for your future. Penn's Basic, Matching, and Supplemental retirement plans allow you to save for retirement on a pre-tax or Roth basis. Choose from a wide variety of investment options through TIAA and Vanguard.

    Time Away from Work: Penn provides you with a substantial amount of time away from work during the course of the year. This allows you to relax, take vacations, attend to personal affairs, recover from illness or injury, spend time with family-whatever your personal needs may be.

    Long-Term Care Insurance: In partnership with Genworth Financial, Penn offers faculty and staff (and your eligible family members) long-term care insurance to help you cover some of the costs of long-term care services received at home, in the community or in a nursing facility. If you apply when you're newly hired, you won't have to provide proof of good health or be subject to underwriting requirements. Eligible family members must always provide proof of good health and are subject to underwriting.

    Wellness and Work-life Resources : Penn is committed to supporting our faculty and staff as they balance the competing demands of work and personal life. That's why we offer a wide variety of programs and resources to help you care for your health, your family, and your work-life balance.

    Professional and Personal Development: Penn provides an array of resources to help you advance yourself personally and professionally.

    University Resources: As a member of the Penn community, you have access to a wide range of University resources as well as cultural and recreational activities. Take advantage of the University's libraries and athletic facilities, or visit our arboretum and art galleries. There's always something going on at Penn, whether it's a new exhibit at the Penn Museum, the latest music or theater presentation at the Annenberg Center, or the Penn Relays at Franklin Field to name just a few examples. As a member of the Penn community, you're right in the middle of the excitement-and you and your family can enjoy many of these activities for free.

    Discounts and Special Services : From arts and entertainment to transportation and mortgages, you'll find great deals for University faculty and staff. Not only do Penn arts and cultural centers and museums offer free and discounted admission and memberships to faculty and staff. You can also enjoy substantial savings on other goods and services such as new cars from Ford and General Motors, cellular phone service plans, movie tickets, and admission to theme parks.

    Flexible Work Hours: Flexible work options offer creative approaches for completing work while promoting balance between work and personal commitments. These approaches involve use of non-traditional work hours, locations, and/or job structures.

    Penn Home Ownership Services: Penn offers a forgivable loan for eligible employees interested in buying a home or currently residing in West Philadelphia, which can be used for closing costs or home improvements.

    Adoption Assistance: Penn will reimburse eligible employees on qualified expenses in connection with the legal adoption of an eligible child, such as travel or court fees, for up to two adoptions in your household.

    To learn more, please visit: https://www.hr.upenn.edu/PennHR/benefits-pay
  • 18 Days Ago

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Medical Policy Coordinator
  • Independence Blue Cross Careers
  • Philadelphia, PA FULL_TIME
  • Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals. If this describes you, we want to speak with you. ...
  • 2 Months Ago

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Mid-Atlantic Policy Manager
  • Appalachian Mountain Cl
  • Bethlehem, PA FULL_TIME
  • The Appalachian Mountain Club (AMC) is seeking a talented and enthusiastic conservation advocate and public policy professional to lead our coalition-based work to advance conservation and recreation ...
  • 16 Days Ago

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Mid-Atlantic Policy Manager
  • Appalachian Mountain Cl
  • Bethlehem, PA FULL_TIME
  • The Appalachian Mountain Club (AMC) is seeking a talented and enthusiastic conservation advocate and public policy professional to lead our coalition-based work to advance conservation and recreation ...
  • 1 Month Ago

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Manager, Climate Communications and Policy
  • CHOOOSE
  • Philadelphia, PA FULL_TIME
  • CHOOOSE is a climate tech company that provides digital solutions to enable decarbonization programs in hard to abate sectors, including aviation, shipping, and logistics. The company has raised $50M ...
  • 2 Months Ago

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General Manager
  • General Manager
  • Annville, PA FULL_TIME
  • We are an established manufacturing company listed on the NYSE with numerous plants across the country. Currently we are seeking candidates for the position of General Manager for our plant located be...
  • 19 Days Ago

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Head of Medical Writing
  • Aerovate Therapeutics, Inc.
  • Waltham, MA
  • Aerovate (AVTE) is a clinical stage biopharmaceutical company focused on developing drugs that meaningfully improve the ...
  • 4/15/2024 12:00:00 AM

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Senior Director, Global Pharmacovigilance & Risk Management Head of Medical Safety
  • Vir Biotechnology, Inc.
  • Vir Biotechnology, Inc. is an immunology company focused on combining cutting-edge technologies to treat and prevent inf...
  • 4/15/2024 12:00:00 AM

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Medical Management Specialist - Looking for RN, LPC, OR LMSW
  • Innovative Systems Group
  • Chicago, IL
  • Job Description Job Description JOB PURPOSE: This position is responsible for conducting medical management and health e...
  • 4/15/2024 12:00:00 AM

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Regional Medical Lead - West
  • HeartFlow
  • Dallas, TX
  • HeartFlow, Inc. is a medical technology company advancing the diagnosis and management of coronary artery disease, the #...
  • 4/14/2024 12:00:00 AM

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Adjunct faculty - Master of Medical Management program
  • Carnegie Mellon University
  • Pittsburgh, PA
  • ** Location** Pittsburgh, PA ** Description** The cyber security component of the Digital Transformation class requires ...
  • 4/14/2024 12:00:00 AM

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Medical Director, Medical Management
  • Imperial Health Plan of California, Inc.
  • Pasadena, CA
  • People are the most important asset of Imperial, for this reason the difference and plurality of people, equality of opp...
  • 4/13/2024 12:00:00 AM

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Executive Director, Head of Medical Affairs, Immunology
  • Rbw Consulting
  • Philadelphia, PA
  • A major international pharma business is looking to expands its immunology pipeline and requires a dynamic and forward t...
  • 4/11/2024 12:00:00 AM

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Medical Management Services Manager - RN Required (on-site)
  • CalViva Health
  • Fresno, CA
  • Job Description Job Description POSITION SUMMARY: This position is responsible for oversight and management of CalViva H...
  • 4/11/2024 12:00:00 AM

Pennsylvania (/ˌpɛnsɪlˈveɪniə/ (listen) PEN-sil-VAY-nee-ə), officially the Commonwealth of Pennsylvania, is a state located in the northeastern and Mid-Atlantic regions of the United States. The Appalachian Mountains run through its middle. The Commonwealth is bordered by Delaware to the southeast, Maryland to the south, West Virginia to the southwest, Ohio to the west, Lake Erie and the Canadian province of Ontario to the northwest, New York to the north, and New Jersey to the east. Pennsylvania is the 33rd-largest state by area, and the 6th-most populous state according to the most recent of...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Manager jobs
$130,584 to $159,416

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