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  • State Licensed Clinical Policy Manager - Lincoln - VirtualVocations

    VirtualVocations
    VirtualVocations Lincoln

    4 days ago

    $90,000 - $120,000 (USD) per year *
    Description

    Job Description

    The company is looking for a Manager, Clinical Policy to join their Clinical Policy team.

    • Clinically evaluate vendor policy sets to ensure compliance with internal and external standards
    • Vet vendor policy sets for affordability opportunities aligned with departmental and organizational goals
    • Track deliverables to meet SLAs and TAT, and prepare materials for executive review and feedback

    Required Qualifications:

    • Bachelor's degree in a relevant field (PA, NP, APRN, BSN, or RN)
    • Active, unrestricted clinical license
    • 4+ years of experience in clinical policy development or evaluation, particularly in health insurance
    • 4+ years of experience in utilization management and/or clinical operations
    • Working knowledge of medical coding (CPT, ICD-10, HCPCS) and claims

    Important skills:

    • Clinical policy development
    • Clinical operations
    • Utilization management
    • Medical coding
    * This salary range is an estimation made by beBee
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