Manager, Medical Review UnitSmyrna, Georgia Apply Now Job ID 1152764 Category Leadership Organization Peach State Health Plan Schedule Full-time
Position Purpose: Manage the review of medical claims for billing coding and other compliance or reimbursement related issues, assist with non clinical aspects of the medical review and project management functions such as gathering information.
Education/Experience: Nursing degree and state registered nursing license with an advanced degree preferred. 3+ years nursing experience and 3–5 years of quality improvement and management experience in a healthcare environment, preferably managed care. Thorough knowledge of Physician’s Current Procedural Terminology (CPT) and International Classification of Diseases, 9th Edition (ICD-9). Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.
License/Certification: RN license.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
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