Medical Management Cover Letter

I submit this application to express my sincere interest in the medical management position.

In my previous role, I was responsible for support for the Patient Care Committees and the Facility Medical Directors/Utilization Management Physicians in MCMG offices regarding utilization management process and consultations of individual cases and referral decisions as well as preferred specialty network for managed care and ACO populations.

My experience is an excellent fit for the list of requirements in this job:

• Quick learner, with experience working in a fast paced and changing environment
• Experience in clinical development within a pharmaceutical company is preferred
• Experience in benefit-risk management within Pharmacovigilance is preferred
• OEM Project Management Preferred
• Experience with Fortune 500 customers
• Experience starting a new case management program growing existing programs
• Experience in health plan clinical decision making process using standardized criteria sets (Milliman, IQ)
• Technologically proficient in various health plan care management systems and workflows, and MS office suite products (Word, Excel, PowerPoint)

I submit this application to express my sincere interest in the medical management position.

Previously, I was responsible for leadership to utilization management team to ensure cost effective and high – quality medical care.

My experience is an excellent fit for the list of requirements in this job:

• Schedules on-site interviews/recruitment opportunities for department
• Provides one hour lunch coverage for front desk reception
• Communicates and interprets administrative and operating policies and procedures
• Assists in the preparation and coordination of records, statistics, and reports regarding operations, etc
• Follow detailed guidelines, instructions and procedures given by management and staff
• Requires knowledge of medical terminology, disease processes, disease registries, medical decision making
• Requires excellent verbal communication, negotiation, motivational interviewing / coaching, and interpersonal skills
• Current state registrations, license, or certification as appropriate to education

In response to your job posting for medical management, I am including this letter and my resume for your review.

In my previous role, I was responsible for professional leadership and direction to the functions within the Medical Management Department (Utilization/Cost Management and Quality Management).

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

• Experience in data analysis, such as creating reports, determining root causes, measuring processes and outcomes, and demonstrating improvements
• Strong preference for experience and knowledge of medical cost and clinical domains
• A true innovator with a passion for making an impact
• A professional with a strong entrepreneurial spirit
• Successful experience working with and being a trusted advisor to business management
• A proven track record operating in a matrixed environment and driving business improvements
• Attention to detail and fact-based analysis
• A complete team player who is able to effectively work across multiple functions, cultures and personalities

In response to your job posting for medical management, I am including this letter and my resume for your review.

Previously, I was responsible for strategic direction for utilization management requirements to improve quality and lower cost for medical benefit products.

My experience is an excellent fit for the list of requirements in this job:

• Health care knowledge including commercial and Medicare/Medicaid health plans
• Computer skills, Microsoft skills, Internet skills
• Extensive experience in UM and CM management in some other setting, or extensive experience in a payer setting, preferably in medical management strongly preferred
• Familiarity with risk management in a healthcare system or large medical group practice or with medical malpractice claims and case management
• Knowledge of trial law and procedure
• Familiarity with clinical risk management, patient safety and continuous quality improvement
• Conversant with data analysis techniques and functionality of RMIS systems
• Schedules appointments and travel arrangements

I submit this application to express my sincere interest in the medical management position.

In the previous role, I was responsible for physician support and leadership for care management rounds and care planning activities to support clinical and utilization management for all products as required.

Please consider my experience and qualifications for this position:

• BS/BA Health Educator
• Full-time experience as a clinical reviewer and administrator in a Medicare or state-level Medicaid program, Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), large Health Care Organization, health plan or any combination thereof
• Microsoft product experience inclusive of Word, Excel, and PowerPoint
• Previous experience managing Medicare Advantage programs preferred
• Takes initiative, Drives innovation and change
• Medical device development experience is highly desirable
• Previous experience managing development teams and/or programs in the medical device industry is preferred
• Previous experience managing R&D mechanical and electrical development programs is preferred