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This position is responsible for the oversight of clinical review and the direction of UM staff to ensure productivity and quality standards are met at all times. The manager must have a comprehensive knowledge of all state and federal regulations in addition to accreditation standards related to UM and ensure compliance and maintenance of Medica's accreditation status and audit performance. The manager will also maintain confidentiality of all privileged information.
This role is critical to Medica and is also responsible for the improvement of UM and Clinical appeals processes through implementation, evaluation and intervention as well as the ability to identify strategic opportunities to improve broader Medica process issues and gaps. The manager understands, articulates, and supports the organization's mission, vision, goals and strategies.
The manager partners with internal and external stakeholders to develop and optimize interventions to facilitate and manage the utilization of health care services.
Qualifications
Required Licensure
Skills and Abilities
This position is a Hub role, which requires an employee to occasionally come onsite to the designated office - Minnetonka, MN - for applicable heads-up work. Frequency is determined by business need as decided by leadership.
The full salary range for this position is $85,000 - $145,700. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.
The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.
Medica's commitment to diversity, equity and inclusion (DEI) includes unifying our workforce through learning and development, recruitment and retention. We consistently communicate the importance of DEI, celebrate achievements, and seek out community partnerships and diverse suppliers that are representative of everyone in our community. We are developing sustainable programs and investing time, talent and resources to ensure that we are living our values. We are an Equal Opportunity/Affirmative Action employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
Full Time
$105k-135k (estimate)
03/20/2024
04/28/2024
medica.com
WAITE PARK, MN
1,000 - 3,000
1975
Private
DENNIS LOHMANN
$200M - $500M
Medica is a health insurance company that provides health insurance products for the individual, family and government markets.