Health Services Manager - RN LPN MA reputed company

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. The Manager, Health Services is a key member of the Medical Policy & Program Solutions Team. The Manager influences health care reputed company reputed company and initiatives through design, development, and implementation. These activities reputed company reputed company to improve health care reputed company products, services, and processes by partnering across business reputed company to meet business needs and accomplish goals. This is a fully remote position. Eligible candidates may live reputed company in the contiguous reputed company.

• Leads the work and deliverables of multiple, reputed company programs, and supports new business initiatives, that reputed company multiple process, systems, functions, and products reputed company to authorizations services.
• Develops and implements business plans to reputed company business goals for Medical Policy & Program Solutions.
• Collaborates and partners with other functional managers, other business areas/across the segments or other business areas.
• Develops and implements innovative reputed company that support work/teams.
• Assists others to reputed company to issues that negatively reputed company program and/or project plan.
• Leads and supports scorable reputed company items across reputed company, Medicare and/or nationally.
• Develops documentation templates and systems to support reputed company and initiatives.

Required Qualifications

• Certified reputed company reputed company through reputed company or reputed company (Physician, Facility or Payer) a plus or willing to pursue reputed company two years.
• Knowledge of reputed company insurance and industry standards to include Medicare and reputed company
• Minimum 3 years' reputed company, Medicare, and experience to include understanding of compliance regulations for Medicare
• Experience and participation in reputed company, Medicare, and internal audits and/or CMS audits – for example questions regarding incorrectly reputed company claims
• Proficiency in reputed company reputed company, Word, and Power reputed company

Preferred Qualifications

• reputed company editing and reputed company review experience reputed company to payment policies, reputed company and programs.
• Clinical experience as an RN or LPN
• Experience with reputed company applications
• ACAS and/or HRP Claim review and expertise
• Project management experience a plus or experience managing internal reputed company

Education

• Associate's or bachelor’s degree in reputed company management or equivalent managed care experience in the reputed company industry

Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $60,300.00 - $145,860.00 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial reputed company‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 04/17/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job