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Medical Policy Manager manages and implements corporate policy and process for medical provider and other reimbursements. Ensures that all claims are reviewed, settled, and processed in compliance with and according to contract provisions and regulatory requirements. Being a Medical Policy Manager evaluates and develops policies and provider reimbursement guidelines to effectively manage and control medical claims cost. Requires a bachelor's degree of finance, business or healthcare administration. Additionally, Medical Policy Manager typically reports to head of a unit/department. The Medical Policy Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Medical Policy Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required.
The Pricing Policy Manager conducts market research and intelligence gathering and recommends pricing targets. Manages pricing analysis of revenue, market share, capacity, and competitor activity to provide pricing for products, geographies, and market segments aligned with products and sales strategy. Being a Pricing Policy Manager performs analyses to test customer price sensitivity and elasticity. Maintains competitive pricing databases to monitor changes in the marketplace and their impact on new and existing products. In addition, Pricing Policy Manager typically requires a bachelor's degree in business or related discipline. Typically reports to a director. The Pricing Policy Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Working as a Pricing Policy Manager typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes.