Manager, Medical Affairs — Remote

Job overview

The Manager, Medical Affairs role is fully remote, working Eastern Time Zone business hours. Compensation is described as competitive, with no numeric amount specified. The role leads a medical policy team responsible for local coverage determinations and local contractor pricing. The manager oversees policy development and implementation, team workload, stakeholder communication, quality controls, and required reporting. The work supports accurate claims processing and compliant medical policy operations in coordination with Medical Directors and operational teams.

What you'll do

• Lead the Medical Policy Team and oversee Local Coverage Determination research, development, communication, education, analysis, and reconsideration
• ensure effective LCD edits are established and implemented in claims systems
• oversee stakeholder engagement, advisory committee and open meetings, and timely handling of medical policy and clinical inquiries
• oversee contractor pricing
• supervise team workload and performance
• lead quality monitoring, root-cause analysis, and corrective action
• collaborate on process improvements
• ensure required CMS reports are submitted accurately and on time.

What we're looking for

Skills & competencies

manager, medical affairs

remote

arc group

medical policy

medicare

local coverage determinations

claims processing

contractor pricing

registered nurse license

eastern time zone

permanent u.s. work authorization

Work arrangement

• Weekend coverage required

Benefits & perks

• Competitive salary, bonus, and a generous benefits package are stated
• specific benefit details are not provided.

Why this role

Fully remote; Eastern Time Zone business hours; active and current Registered Nurse license required; permanent U.S. work authorization required; bachelor's degree and five years of related Medicare experience required.

About the employer

ARC Group is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.