The Clinical Product Manager is responsible for supporting the Director of Clinical Optimization in the implementation, process improvement, and optimization of clinical programs. The Clinical Product Manager will be responsible for analytic measurement and improvement of medical management of their assigned programs. These programs may include pharmacy, networks (MPN, HCN, OBN), DME, PT, diagnostics, and other medical interventions. This role will achieve outcomes by focusing on analytics, clinical operations, and development of new programs to support organizational vision, and cost savings. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust organization. savings.
- Serve as a business resource for medical data/analytic needs and establishing key performance indicators, identifying opportunities, and driving business goals
- Monitor, analyze, and trend clinical program data to assist the Director of Clinical Optimization in the development, implementation, and driving of key initiatives for ancillary clinical such as pharmacy, networks (MPN, HCN, OBN), DME, PT, DX
- Optimize clinical programs for nurse and adjuster efficiency, streamlined injured employee experience, and positive claim outcome
- Manage day to day issues with clinical program management interfacing with vendors and internal staff
- Identifies best practices and trends in the industry, participates in evaluating new and emerging technologies and treatments to determine possible incorporation into clinical ancillary program
- Participate in office managed care and clinical operational reviews
- Manages project development/enhancements through coordination with WC operations
- Keeps current with market trends and demands
- Performs other functionally related duties as assigned
- Minimum B.S. or B.A. Degree
- 3+ years of managing projects and/or vendor relationships
- 3+ years of experience writing complex SQL queries, creating stored procedures, views, and functions
- Proficient in data mining and data visualizations
- Experience the health care management setting, insurance carrier setting or related industry
- Proficiency in all Microsoft Office products including Project, Word, Excel, PowerPoint, Visio, and SharePoint
- Project Management Office (PMO) experience preferred
- 2+ years of management experience preferred
- Ability to lead any necessary process improvement efforts needed to mature organization
- Demonstrated results in developing strategic plans and executing key initiatives
- Excellent English communication skills, written and verbal, as well as strong analytic, documentation, and organizational skills
- Efficient with multitasking between projects
- Knowledge of workers' compensation laws and regulations, medical billing (ICD9/10, CPT, HCPCS)
- Experience with State and external accreditation managed care audits and with writing and implementing program level policy and procedures
- Ability to prepare and effectively communicate presentations, interpret/develop reports, metrics and improvement plans, and to interact collaboratively and work effectively with a multi-functional team and throughout the organization; fosters an environment of shared responsibility and accountability
- Ability to meet or exceed Performance Competencies and to collaborate across functional lines and leaders
This job description is designed to provide a general overview of the requirements of the job and does not entail a comprehensive listing of all activities, duties, or responsibilities that will be required in this position. AmTrust reserves the right to revise this job description at any time.
What We Offer
AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.
AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.
AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future.
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