Mgr II Medical Management (Maternity - HMC)

WellPoint is the nation's leading health benefits company serving the needs of approximately 28 million medical members nationwide.



Work schedule:  Monday - Friday (12:30pm to 9:00pm)

 

Responsible for the management of clinical staff in a medical management area, which may include utilization management, medical review, case management, etc.. . Essential duties may include, but are not limited to: Manages daily operation needs for the one or more areas of medical management. Manages implementation of local medical policies and procedures in collaboration with the Medical Director. Manages service issues within the unit to ensure that productivity, performance and quality standards are met. Identifies process and work flow issues as well as recommendations for improvement. Leads company project initiatives. Management duties to include hiring, training, coaching, counseling and evaluating performance of direct reports. Performs other duties as assigned.

Requires active state RN license. Requires BA/BS and 4-5 years experience in managed care specifically in utilization, medical review, or case management areas. Progressive management experience required. Excellent written, oral and interpersonal communication skills required. Excellent analytical and problem-solving skills required. Strong computer skills, organizational skills, and tactical planning skills required. Must show evidence of leadership and project management skills.