Medical Management Manager jobs in South Dakota

Medical Management Manager manages the organization's medical management programs, which may include case management, utilization review, quality management, or community health education programs with the goal of providing high quality, cost effective health care services. Collects and analyzes data on utilization, outcomes, safety, and costs to determine trends and identify problem areas. Being a Medical Management Manager presents findings, proposed solutions, and implementation plans to management. Implements long and short term solutions for improvements in patient care and cost savings. Additionally, Medical Management Manager requires a bachelor's degree. Typically reports to a head of a unit/department. The Medical Management 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 Management 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)

A
Registered Nurse (RN) - Case Manager - Medical Management
  • Avera Health Plans
  • Baltic, SD FULL_TIME
  • Join the team at Avera!

    Award Winning Health Care

    Avera has been named among the nation’s 15 Top Health Systems, Forbes list of America’s Best-in-State Employers and Level 10 Most Wired Health Care Organization by CHIME.

    Culture

    Be part of a multidisciplinary team built on teamwork, with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.

    You Belong At Avera

    Competitive pay, front-loaded PTO and options for free health insurance, sign-on bonuses, various shifts to fit your lifestyle and opportunities for career growth.

    Avera is looking for a Registered Nurse (RN) - Case Manager to join our Team!

    Position Highlights

    Paid Time Off (PTO) available on Day 1!

    Options for Free Health Insurance!

    This position has the opportunity to work remotely!

    Positive Work Environment

    Be part of an organization where we practice the mission in our daily operations and demonstrate our pride by delivering excellent care.

    Job Summary

    The RN Case Manager is a specialized nurse that identifies members who would benefit from complex/chronic condition case management and/or service coordination.

    The RN Case Manager develops and facilitates the member’s plan of care. In collaboration with physicians, population health staff, employers, community organizations, hospital-based case managers/utilization review staff, clinic-based care coordinators/preauthorization staff, and Insurance Division staff, the RN Case Manager encourages the best possible outcome in the most cost effective manner in accordance with standards set forth by National Committee for Quality Assurance (NCQA).

    The RN Case Manager will need to be knowledgeable in various aspects of all health plan lines of business, inclusive of commercial, marketplace, and self-funded clients.

    The position requires interaction with health system stakeholders, key opinion leaders, vendors, delegated entities, healthcare providers, policy makers, and accreditation and government organizations.

    Education and/or Experience

    Graduate from an accredited RN program (Associate’s degree or Bachelor of Science degree).

    Four years of professional nursing practice experience preferably in the acute care setting.

    Case-management, disease-management, care coordination or equivalence preferred.

    Proficient in Microsoft Word, Excel, Access and Power Point.

    Familiarity with data extraction tool is desirable.

    Licensure/Certification/Registration

    Licensed as a Registered Nurse in the state of South Dakota and/or meeting the requirements of the enhanced Nursing Compact Licensure (eNCL) required.

    Registered Nurse in the state of Minnesota or within 120 days of employment required.

    Certification in Case Management, Managed Care Nursing or a related specialty to be completed within 2 years of hire date.

    Work Schedule

    Monday - Friday; 80 hours every 2 weeks

    8:00 am - 5:00 pm

    Pay

    The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

    $29.50- $44.25 per hour

    What Makes Avera Special?
  • 2 Days Ago

A
Registered Nurse (RN) - Case Manager - Medical Management
  • Avera Health Plans
  • Hartford, SD FULL_TIME
  • Join the team at Avera!Award Winning Health CareAvera has been named among the nation’s 15 Top Health Systems, Forbes list of America’s Best-in-State Employers and Level 10 Most Wired Health Care Orga...
  • 3 Days Ago

A
Registered Nurse (RN) - Case Manager - Medical Management
  • Avera Health Plans
  • Lennox, SD FULL_TIME
  • Join the team at Avera!Award Winning Health CareAvera has been named among the nation’s 15 Top Health Systems, Forbes list of America’s Best-in-State Employers and Level 10 Most Wired Health Care Orga...
  • 3 Days Ago

A
Registered Nurse (RN) - Case Manager - Medical Management
  • Avera Health Plans
  • Canton, SD FULL_TIME
  • Join the team at Avera!Award Winning Health CareAvera has been named among the nation’s 15 Top Health Systems, Forbes list of America’s Best-in-State Employers and Level 10 Most Wired Health Care Orga...
  • 3 Days Ago

A
Registered Nurse (RN) - Case Manager - Medical Management
  • Avera Health Plans
  • Renner, SD FULL_TIME
  • Join the team at Avera!Award Winning Health CareAvera has been named among the nation’s 15 Top Health Systems, Forbes list of America’s Best-in-State Employers and Level 10 Most Wired Health Care Orga...
  • 3 Days Ago

A
Registered Nurse (RN) - Case Manager - Medical Management
  • Avera Health Plans
  • Sioux Falls, SD FULL_TIME
  • Join the team at Avera!Award Winning Health CareAvera has been named among the nation’s 15 Top Health Systems, Forbes list of America’s Best-in-State Employers and Level 10 Most Wired Health Care Orga...
  • 3 Days Ago

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

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Hospital Medical Leader
  • Petco
  • Deerfield Beach, FL
  • 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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Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Noblesville, IN
  • 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

E
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

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

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Hospital Medical Leader
  • Petco Animal Supplies, Inc.
  • Plainview, NY
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 6/7/2024 12:00:00 AM

South Dakota (/- dəˈkoʊtə/ (listen)) is a U.S. state in the Midwestern region of the United States. It is named after the Lakota and Dakota Sioux Native American tribes, who compose a large portion of the population and historically dominated the territory. South Dakota is the seventeenth largest by area, but the fifth smallest by population and the 5th least densely populated of the 50 United States. As the southern part of the former Dakota Territory, South Dakota became a state on November 2, 1889, simultaneously with North Dakota. Pierre is the state capital and Sioux Falls, with a populat...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Management Manager jobs
$100,093 to $124,364

Medical Management Manager in Pocatello, ID
Also, the business side of the practice is very complex. There are many intricacies that a medical office manager must learn, monitor, and control to some extent.
January 14, 2020
Medical Management Manager in Lubbock, TX
The program’s part-time structure is focused on developing you to be confident manager and leader who can make key financial, operational, and strategic decisions for your organization.
February 04, 2020
Medical Management Manager in Concord, NH
Three, if you want to make the comparison, medical management is like handling an insane amount of projects at the same time every day, which is equal to the number of patients your clinic (every case is a separate case or a separate project for that matter) has for every given day.
February 07, 2020