| Medical Policy Manager Job Description |
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| The following is a full job description for Medical Policy Manager. Here are the requirements and responsibilities for Medical Policy Manager along with statistics. If after reading this page you determine that Medical Policy Manager is not the position you are looking for, you may want to try one of these similar titles: Medical Policy Specialist, Medical Records Coding Policy Administrator, Medical Billing Specialist, Medical Writer III, Finance Manager, Medical Management Manager, Medical Writing Manager, Policy Change Supervisor, Medical Claims Review Manager |
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| Requirements and Responsibilities For 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. 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. Typically reports to head of a unit/department. 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. Typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. |
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| Also referred to as: Provider Claims Process and Controls Manager |
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| Similar Jobs: Medical Policy Specialist, Medical Records Coding Policy Administrator, Medical Billing Specialist, Medical Writer III, Finance Manager, Medical Management Manager, Medical Writing Manager, Policy Change Supervisor, Medical Claims Review Manager |
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| Level of Education: Medical Policy Manager Salaries with a Bachelor's Degree, Medical Policy Manager Salaries with a Master's Degree or MBA, Medical Policy Manager Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Edu., Gov't. & Nonprofit, Healthcare, Insurance | |
