California Licensed Medical Review Manager
Job Summary
To drive clinical quality and operational efficiency, the full-time California Licensed Medical Review Manager will oversee multidisciplinary teams of healthcare professionals, ensuring high-quality medical necessity reviews and regulatory compliance in a remote environment.
Key responsibilities
- Provides strategic leadership and oversight for teams conducting medical necessity determinations and clinical quality reviews
- Ensures compliance with regulatory, accreditation, and organizational requirements governing medical review operations
- Identifies and implements process improvements to enhance clinical review quality and efficiency
Required qualifications
- Master's degree in business administration, engineering, information systems, or related field preferred
- Twelve or more years of support services, project, or program experience
- Eight or more years of leadership or supervisory experience
- Experience working with the technology industry and company products
- Experience in proposal development and operational planning
Complete Job Description
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