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Salary Survey Data - Medicaid Marketing Director in York, Pennsylvania

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Medicaid Marketing Director in York, Pennsylvania

Directs and manages medical service departments that may include utilization management, inpatient case management, ambulatory case management, disease management, appeals, and support functions of the health plan. Develops and implements programs for determining levels and implementing changes in utilization, quality, and cost of medical care. Prepares policies and procedures to ensure compliance with regulatory agencies. Typically requires licensure as a Registered Nurse or significant experience in the administration of health programs. Develops and conducts educational programs for department staff and providers. Participates in committees for the development of standards of care for concurrent and retrospective review. Develops guidelines to evaluate overutilization and underutilization of services. Reviews and analyzes the inpatient census to determine workload, resource needs, and opportunities for reducing utilization or length of stay. Prepares and manages the departmental budget. Hires, develops, and motivates a qualified medical department staff.

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