Medical Claims Review Manager jobs in Kansas

Medical Claims Review Manager oversees the performance, productivity, and quality of the medical claims review staff. Responsible for hiring, training, and firing medical claims review staff. Being a Medical Claims Review Manager evaluates medical claims review processes and recommends process improvements. Serves as a technical resource for all medical review workers. Additionally, Medical Claims Review Manager typically requires an RN or BSN. Requires a bachelor's degree. Typically reports to a head of a unit/department. The Medical Claims Review 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 Claims Review 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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Medical Review - Pleno/Sênior
  • Mollica IT
  • Home, KS FULL_TIME
  • Buscando projetos internacionais?

    Então vem com a Mollica IT e encontre a oportunidade certa pra dar match!

    Estamos em busca de profissionais inovadores e criativos, que tenham paixão em crescer, evoluir e aprender.

    Qual Será a Sua Missão

    • Fornecer uma análise de causalidade da empresa usando as informações clínicas disponíveis no banco de dados de segurança (Argus) para ensaios clínicos, estudos espontâneos, pós-comercialização, tipos de casos legais e de literatura;
    • Revisar os relatos de casos para obter sentido médico, o que pode incluir a validação da lista de eventos adversos e a correção do evento;
    • Solicitar informações de acompanhamento adequadas para garantir que o relatório do caso contém informações suficientes para realizar uma avaliação robusta da causalidade do caso;
    • Demais rotinas da área.

    📌 Em caso de dúvidas, entre em contato com selecao@mollicait.com

    O Que Você Precisa Ter

    • Experiência em Medical Review;
    • Sólida compreensão do processo de segurança e regulamentação de medicamentos;
    • Conhecimentos de segurança de medicamentos, desenvolvimento clínico e princípios ICH/GCP;
    • Bom conhecimento das práticas de farmacovigilância;
    • Boa capacidade de resolução de problemas e tomada de decisão;
    • Obrigatório Graduação completa;

    Desejável

    • Sólida compreensão do processo de segurança e regulamentação de medicamentos;
    • Conhecimento dos requisitos regulatórios de farmacovigilância dos EUA e da UE será uma vantagem;
    • Excelentes habilidades de comunicação escrita e verbal e capacidade de apresentar e discutir criticamente dados clínicos em discussões internas e externas Capacidade de avaliar e interpretar dados clínicos (pensamento analítico);
    • Conhecimentos em MS Office;

    🌎 Idioma

    • Inglês Avançado para conversação (Haverá etapa de entrevista nesse idioma)

    ✔️Assistência Médica para colaboradores e dependentes com abrangência nacional da Bradesco ou Unimed

    ✔️Assistência Odontológica com abrangência nacional

    ✔️Vale Refeição ou Vale Alimentação (a escolha do colaborador)

    ✔️Auxílio creche

    ✔️Seguro de Vida para associados e dependentes

    ✔️Gympass para associados e dependentes

    ✔️EAP (Employee Assistance Program) com os seguintes serviços: Assistência Financeira, Assistência Jurídica, Assistência Social, Assistência Psicológica (24 horas - 7 dias por semana).

    ✔️Descontos e tarifas diferenciadas junto a Universidades (Mackenzie, SENAC, FIA, FIAP e BBS Business School) e escola de idiomas (CNA, Cultura Inglesa, Wizard, CCAA, Indeed).

    ✔️Descontos em pacotes de tarifas e taxas diferenciadas para Bancos Itaú e Bradesco

    ✔️Opção de crédito consignado, com desconto diretamente no salário do colaborador

    ✔️Programa de reembolso de algumas certificações externas

    ✔️Treinamento: A TCS oferece plataforma de treinamento e desenvolvimento a distância e presencias, em soft skills, tecnologias e domínios em mais de 15.000 temas.

    ✔️Premiação por tempo de casa: A TCS premia associados por seu comprometimento e lealdade durante o período em que trabalhar na empresa (3, 5 e 10 anos e cada 5 anos posteriormente).

    ✔️Prêmio de indicação de novos colaboradores - recebendo um bônus para cada nova contratação.

    ✔️TCS Fit4life - Programa para incentivar a prática de exercício físico junto a seus associados, com agenda de treinamentos funcionais online.

    ✔️Experiência internacional: Dependendo de seus conhecimentos e das demandas do negócio você pode se candidatar a vagas no exterior (dentro e fora da América Latina).

    ✔️Entre outros;

    Contratação: CLT

    Prazo: Indeterminado

    Local: Home Office - Aceitamos Pessoas Candidatas de todo o Brasil

    Horário: Das 8h00 às 17h00
  • 5 Days Ago

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Medical Review Officer Physician
  • Health eCareers
  • Medora, KS FULL_TIME
  • Job Description & RequirementsMedical Review Officer PhysicianStartDate: ASAP Pay Rate: $220000.00 - $220000.00Our established practice is looking for a family medicine, internal medicine or occupatio...
  • 6 Days Ago

C
Claims Manager
  • CorVel Corporation
  • Overland Park, KS FULL_TIME
  • The Claims Manager is responsible for the overall operation of a designated office. The Claims Manager participates in formulating and administering company best practices as well as developing long-r...
  • 8 Days Ago

C
Claims Manager
  • CorVel Brand
  • Overland Park, KS FULL_TIME
  • The Claims Manager is responsible for the overall operation of a designated office. The Claims Manager participates in formulating and administering company best practices as well as developing long-r...
  • 12 Days Ago

C
Medical Only Claims Specialist
  • CorVel Corporation
  • Overland Park, KS FULL_TIME
  • The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of claims...
  • 9 Days Ago

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Medical Claims Representative Trainee
  • Progressive Insurance
  • Kansas, KS FULL_TIME
  • As a medical claims representative trainee, you’ll be instrumental in keeping the medical claims process efficient and supportive for our customers. Focusing on personal injury protection medical cove...
  • 11 Days Ago

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Hospital Medical Leader
  • Petco
  • Folsom, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 6/10/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Alameda, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 6/9/2024 12:00:00 AM

P
Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Fairfield, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 6/9/2024 12:00:00 AM

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Head of Medical Writing
  • Barrington James
  • Clinical-stage biopharmaceutical company in San Francisco, is seeking a Head of Medical Writing. This leadership role in...
  • 6/8/2024 12:00:00 AM

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Head of Medical Strategy
  • ExecuSearch
  • Atlanta, GA
  • The Head of Medical Strategy provides medical expertise to the rheumatology commercial and medical teams and provides cl...
  • 6/8/2024 12:00:00 AM

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Head of Medical Strategy Rheumatology
  • UCB
  • Atlanta, GA
  • Make your mark for patients The Head of Medical Strategy provides medical expertise to the rheumatology commercial and m...
  • 6/8/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Pinellas Park, FL
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 6/8/2024 12:00:00 AM

B
Head of Medical Writing
  • Barrington James
  • San Francisco, CA
  • Head of Medical Writing - Rare disease Biotech We are currently partnered with a growing, west coast based biotech focus...
  • 6/7/2024 12:00:00 AM

Kansas /ˈkænzəs/ (listen) is a U.S. state in the Midwestern United States. Its capital is Topeka and its largest city is Wichita, with its most populated county being Johnson County. Kansas is bordered by Nebraska on the north; Missouri on the east; Oklahoma on the south; and Colorado on the west. Kansas is named after the Kansa Native American tribe, which inhabited the area. The tribe's name (natively kką:ze) is often said to mean "people of the (south) wind" although this was probably not the term's original meaning. For thousands of years, what is now Kansas was home to numerous and divers...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$93,319 to $118,983

Medical Claims Review Manager in Parkersburg, WV
This end-to-end e-billing and e-payment solution is fully integrated with DecisionPoint, which means it can be immediately and easily integrated with your providers, adjusters, IT infrastructure, and claims workflow—enabling you to.
January 01, 2020
Medical Claims Review Manager in Juneau, AK
Examples include a claims examiner’s view of a particular bill’s status in a claim record’s related bill screen, or a bill review analyst’s view of an available reserve amount for the claim record related to the bill they are processing.
December 03, 2019
Medical Claims Review Manager in Galveston, TX
Assists the Manager, Medical Review with performing duties to oversee day-to-day activities within the Medical Claims Review Department to facilitate the achievement of business goals and targets.
December 16, 2019