Clinical Adjudication Manager

Job Summary

A company is looking for a Clinical Adjudication Manager.

Key Responsibilities

• Plans and manages project activities to meet contract deliverables
• Develops standardized approaches for dissemination and communication of project information
• Manages, trains, and evaluates project work activities and personnel

Required Qualifications

• Associate's degree or 60 or more credit hours towards a Bachelor's degree in healthcare or related discipline
• Five (5) years of clinical or medical administration experience
• Three (3) years of management or supervisory experience
• One (1) year of experience writing or making medical necessity decisions
• Experience relevant to Medicare managed care appeals or utilization management activities is preferred